Nutritional support practices among intensive care units in Turkey: One-day cross-sectional study

Objective: Malnutrition is a significant problem among critically ill patients and is closely associated with poorer patient outcomes. With this study, we aimed to assess nutritional support practices and to evaluate the associated patient outcomes in intensive care units (ICU) in Turkey. Methods: This one-day, cross-sectional study was conducted in November 2015. A total of 1140 patients from 120 ICUs in 46 hospitals across Turkey were included. The general characteristics of the ICUs and patients, clinical data regarding nutritional support, hospitalization courses of the patients, and patient outcomes were recorded. The study questionnaire was prepared by the investigators and was completed by health care professionals from various hospital departments. Results: The mean age of the patients (55.7% were men) was 66.8±18.0 years. The median duration of the ICU stay was 17 days. Enteral tubes were present in 649 patients, of whom 79.4% had nasogastric tubes, 15.3% had percutaneous endoscopic gastrostomy (PEG) tubes, 4% had nasojejunal tubes, and 1.4% had surgical gastrostomy/jejunostomy tubes. 68.1% of ICUs had a nutritional support team. Nutritional support applied included enteral nutrition (44.1%), oral nutrition (25.9%), parenteral nutrition (18.5%), and enteral + parenteral nutrition (11.5%). On the 60th day, the mortality rate was 39.5%. Mortality rates were significantly lower in the oral nutrition group compared with the other groups, and were significantly higher in the parenteral nutrition group compared with the other groups. Conclusion: Our findings confirm the importance of nutritional support teams to provide timely and adequate administration of nutritional support and its association with better patient outcomes. Additionally, better outcomes were obtained with enteral nutrition compared with parenteral nutrition.