Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Assessment of early nutritional state in critical patients with intoxication and the effect of nutritional status on prognosis

중독 중환자에서의 초기 영양상태평가와 예후와의 관계

  • Ko, Dong-wan (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Choi, Sangcheon (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Min, Young-gi (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Lee, Hyuk jin (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Park, Eun Jung (Department of Emergency Medicine, Ajou University School of Medicine)
  • 고동완 (아주대학교병원 응급의학과) ;
  • 최상천 (아주대학교병원 응급의학과) ;
  • 민영기 (아주대학교병원 응급의학과) ;
  • 이혁진 (아주대학교병원 응급의학과) ;
  • 박은정 (아주대학교병원 응급의학과)
  • Received : 2021.07.29
  • Accepted : 2021.08.23
  • Published : 2021.12.31
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Abstract

Purpose: Nutritional status and support in critically ill patients are important factors in determining patient recovery and prognosis. The aim of this study was to analyze the early nutritional status and the methods of nutritional support in critically ill patients with acute poisoning and to evaluate the effect of nutritional status on prognosis. Methods: A retrospective study was conducted in tertiary care teaching hospital from January 2018 to December 2020. in an emergency department of university hospital, 220 patients who were stayed more than 2 days of poisoning in intensive care unit were enrolled. Results: 155 (70.5%) of patients with acute poisoning had low-risk in nutritional risk screening (NRS). Patients with malignancy had higher NRS (low risk 5.2%, moderate risk 18.5%, high risk 13.2%, p=0.024). Patients of 91.4% supplied nutrition via oral route or enteral route. Parenteral route for starting method of nutritional support were higher in patients with acute poisoning of herbicide or pesticide (medicine 3.2%, herbicide 13.8%, pesticide 22.2%, p=0.000). In multivariate logistic regression analysis, herbicide or pesticide intoxication, higher risk in NRS and sequential organ failure assessment over 4.5 were affecting factor on poor recovery at discharge. Conclusion: NRS in patients intoxicated with herbicide or pesticide were higher than that in patients intoxicated with medicine intoxication. Enteral nutrition in patients intoxicated with herbicide or pesticide was less common. Initial NRS was correlated with recovery at discharge in patient with intoxication. It is expected to be helpful in finding patients with high-risk nutritional status in acute poisoning patients and establishing a treatment plan that can actively implement nutritional support.

Keywords

References

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