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Protein, malnutrition and wasting disorders

Appetite during the recovery phase of critical illness: a cohort study

European Journal of Clinical Nutrition volume 72, pages 986–992 (2018)Cite this article

Subjects

Abstract

Background/Objectives

Reduced appetite is a recognised physiological symptom in survivors of critical illness. While reduced appetite has been reported by patients after intensive care unit (ICU) discharge, quantification using visual analogue scales (VAS) has not been previously performed, and follow-up duration has been limited. We aimed to describe appetite scores in ICU survivors during the first 3 months after ICU discharge and explore association with systemic inflammation.

Subjects/Methods

Secondary analysis of data collected in a complex rehabilitation intervention trial (RECOVER). A subgroup of 193 patients provided specific consent for inclusion in the blood sampling sub-study during consent for the main study. We studied appetite using a VAS; serum C-reactive protein (CRP); interleukin-1β and interleukin-6 (IL-1β and IL-6); and hand-grip strength.

Results

Median (interquartile range) score on 0–10 appetite VAS was 4.3 (2.0–6.5) 1 week after ICU discharge, improving to 7.1 (4.6–8.9) by 3 months (mean difference 1.7 (0.9–2.4), p < 0.01). Number of days spent in an acute hospital following an intensive care stay was associated with poorer appetite scores (p = 0.03). CRP concentration and appetite were significantly associated at 1 week after ICU discharge (p = 0.01), but not at 3 months after ICU discharge (p = 0.67).

Conclusions

ICU survivors experience reduced appetite during the acute recovery phase of critical illness that could impact on nutritional recovery and this was associated with CRP concentration 1 week after ICU discharge.

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Acknowledgements

The RECOVER trial on which this analysis is based is registered as ISRCTN09412438. The RECOVER trial work was supported by the Chief Scientists Office, Scotland.

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Authors and Affiliations

  1. Department of Critical Care, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK

    Judith L Merriweather, David M Griffith & Timothy S Walsh

  2. Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh, UK

    David M Griffith & Timothy S Walsh

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  1. Judith L Merriweather
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Correspondence to Judith L Merriweather.

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Merriweather, J.L., Griffith, D.M. & Walsh, T.S. Appetite during the recovery phase of critical illness: a cohort study. Eur J Clin Nutr 72, 986–992 (2018). https://doi.org/10.1038/s41430-018-0181-3

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