Aim: Critically ill hematologic patients (CIHPs) represent a distinct population in the intensive care unit (ICU), characterized by complex pathophysiology and high mortality rates. Prognostic assessment in this group remains challenging. This study aimed to evaluate the utility of acute illness severity and organ dysfunction scores in predicting ICU outcomes in CIHPs. Study Design: This retrospective, single-center study was conducted in a dedicated hematology ICU. The prognostic performance of commonly used acute illness severity and organ dysfunction scores (APACHE II, SAPS II, and SOFA) was evaluated in CIHPs. ICU mortality was assessed as the primary outcome. Additionally, early trajectories of these scores-particularly changes by ICU day 3-were analyzed for their association with prognosis. Results: A total of 107 patients were included. The median age of the patients was 62 (range: 53-70), and 69 (64.5%) were male. The ICU mortality rate was 40.2%. The most frequent underlying diagnoses were multiple myeloma (31.8%) and non-Hodgkin lymphoma (20.6%). Respiratory failure (68.2%) and sepsis (54.2%) were the leading reasons for ICU admission. Non-survivors had significantly higher APACHE II, SAPS II, and SOFA scores on both day 1 and day 3. Furthermore, non-survivors demonstrated a significant increase in all three scores over the first three ICU days. Among these parameters, the day 3 SOFA score was the strongest independent predictor of ICU mortality (OR 2.042, 95% CI 1.407-2.962; p = 0.001), suggesting that early organ dysfunction and its progression during the ICU stay are critical determinants of ICU mortality. Conclusions: Acute illness severity and organ dysfunction scores are valuable tools for predicting ICU outcomes in CIHPs. In particular, early SOFA score trajectories-especially the day 3 SOFA score-provide superior prognostic information and may support clinical decision-making in this high-risk population.
Aim: To investigate the association between ultrasound-derived rectus femoris and parasternal intercostal muscle thickness and weaning outcomes in mechanically ventilated, critically ill patients, as well as their relationship with post-extubation non-invasive mechanical ventilation requirements and 28-day mortality. Study Design: This prospective observational study included 69 mechanically ventilated adult patients undergoing spontaneous breathing trials in a medical intensive care unit. Demographic characteristics, clinical severity scores (modified Nutrition Risk in the Critically Ill [modified NUTRIC] score, Acute Physiology and Chronic Health Evaluation II [APACHE II], Sequential Organ Failure Assessment [SOFA], and Clinical Frailty Scale [CFS]), and ultrasonographic measurements of rectus femoris and parasternal intercostal muscle thickness were obtained at the 30th minute of the spontaneous breathing trial. Patients were classified into weaning success or failure groups based on the absence or presence of reintubation or death within seven days after extubation. Results: The mean rectus femoris thickness was 6.93 +/- 2.31 mm in the weaning success group and 5.96 +/- 2.41 mm in the weaning failure group (p>0.05). Parasternal intercostal muscle thickness was 4.49 +/- 1.25 mm and 4.18 +/- 1.48 mm in the respective groups (p>0.05). Muscle thickness was not associated with weaning success; however, both rectus femoris and parasternal intercostal muscle thicknesses were significantly lower in non-survivors compared with survivors at 28 days. Reduced rectus femoris thickness was also associated with an increased requirement for post-extubation non-invasive mechanical ventilation. In addition, higher modified NUTRIC scores were associated with both weaning failure and 28-day mortality. Conclusions: Ultrasound-based muscle thickness alone was not associated with weaning success; however, reduced rectus femoris and parasternal intercostal muscle thickness were associated with 28-day mortality and an increased requirement for post-extubation non-invasive mechanical ventilation. These findings suggest that ultrasound-based muscle assessment may provide useful prognostic insights for risk stratification in critically ill patients. Further multicenter studies are needed to validate standardized cut-off values and enhance clinical applicability.
Aim: Patient-ventilator asynchrony (PVA), commonly occurring in mechanically ventilated patients, is a significant issue that contributes to increased discomfort, prolonged ventilation, and higher mortality rates. Among various ventilatory modes, Synchronized Intermittent Mandatory Ventilation (SIMV) and Pressure Regulated Volume Control (PRVC) are frequently used, yet their comparative effects on PVA remain unclear. This study aims to evaluate and compare the relationship between SIMV and PRVC ventilatory modes and the type and incidence of asynchrony in trauma patients in the ICU. Study Design: This randomized, outcome-assessor-blinded clinical trial enrolled 100 mechanically ventilated trauma patients in the ICU of a hospital in southern Iran. Patients were randomly assigned to either SIMV or PRVC mode (n=50 in each group). Asynchrony was assessed over a span of 72 hours using standard waveform analysis. The overall incidence of asynchrony was chosen as the primary outcome, while specific types of asynchrony were considered secondary outcomes. Statistical analyses, including t-tests, chi-square tests, and ANOVA, were performed, with a significance level set at p<0.05. Results: Asynchrony was observed in 63% of the patients. Trigger asynchrony was the most prevalent type, affecting 37% of patients. There were no statistically significant associations between the incidence of asynchrony and patient age, gender, or ventilation mode (p>0.05). The rates and distribution of asynchrony were similar for both SIMV and PRVC modes. Conclusions: The significant occurrence of PVA underscores the need for careful, individualized adjustments to ventilator settings. The comparable results obtained with SIMV and PRVC modes suggest that optimizing trigger sensitivity may reduce the impact of mode selection, thus diminishing its importance in clinical decision-making.
Aim: Patients diagnosed with lung cancer may require intensive care due to sudden and severe clinical events; however, early survival outcomes vary widely. In this context, we investigated ICU mortality and analyzed admission-specific clinical characteristics associated with death in a healthcare setting where access to intensive care is not limited by predefined admission criteria. Study Design: The study population consisted of adult individuals with lung cancer who required intensive care from 2018 to 2022. Patient demographics, cancer-related features, indications for ICU admission, illness severity indices, requirements for organ-supportive therapies, and clinical outcomes were systematically evaluated. Associations between baseline variables and ICU mortality were examined using multivariable logistic regression analysis. Results: The study cohort comprised 351 critically ill patients with lung cancer. The median age was 66 years, and ICU mortality occurred in 76% of cases. The presence of metastatic disease independently increased the risk of death (OR 2.32, 95% CI 1.26-4.26). In contrast, patients admitted due to hypercapnic respiratory failure demonstrated a significantly lower mortality risk (OR 0.36, 95% CI 0.17-0.75). Higher illness severity scores were consistently associated with unfavorable outcomes. Conclusions: Despite significant advances in intensive care medicine, short-term outcomes for lung cancer patients admitted to the ICU remain unfavorable. Disease burden, reflected by metastatic status and severity scores, strongly influences outcomes, whereas patients admitted with hypercapnic respiratory failure demonstrate a more favorable prognosis.
Aim: This study aimed to compare the effectiveness and safety of fentanyl infusion with a combination of morphine, ketamine, and lidocaine (multimodal analgesia) for postoperative pain management in patients undergoing coronary artery bypass grafting (CABG). Study Design: This randomized clinical trial was conducted from 2024 to 2025 and included 74 patients undergoing elective CABG at the study hospital. Patients received either fentanyl (500 mu g/100 mL) or a combination of morphine (20 mg), ketamine (20 mg), and lidocaine (200 mg) diluted to 100 mL, administered as an infusion at 4 mL/h for the first 24 postoperative hours. Pain was assessed using the Visual Analog Scale (VAS) at 1, 4, 8, 12, 16, 20, and 24 hours after surgery. Additional recorded parameters included hemodynamic variables, respiratory depression, and the need for rescue analgesia. Results: Patients receiving fentanyl infusion demonstrated a statistically significant greater reduction in pain scores at 4 and 8 hours postoperatively compared to those receiving the multimodal regimen. However, at the remaining assessment times (1, 12, 16, 20, and 24 hours), no significant differences in pain intensity were observed. Over the full 24-hour period, both regimens provided comparable analgesia. Additionally, no significant differences were found between the groups regarding adverse effects or the need for rescue analgesia. Conclusions: Fentanyl infusion demonstrated greater efficacy in early postoperative pain control compared to the multimodal regimen; however, this benefit was of short duration. Over the first 24 hours following surgery, both strategies showed comparable efficacy and safety; therefore, both may be considered viable options for post-CABG analgesia.
Aim: Predicting fluid responsiveness in patients with shock is critical. This study aimed to evaluate the diagnostic accuracy of dynamic ultrasound-derived indices in predicting fluid responsiveness, using bioreactance-based cardiac output monitoring as the reference standard. Study Design: A total of 39 adult patients diagnosed with shock who were receiving mechanical ventilation were included. Hemodynamic parameters were assessed using ultrasound [left ventricular outflow velocity-time integral (LVOT-VTI), respirophasic variability of LVOT-VTI, corrected and the inferior vena cava distensibility index (dIVC)] and pulse pressure variation (PPV) via invasive arterial monitoring. The bioreactance-derived stroke volume index change after passive leg elevation (Delta SVI >= 10%) served as the reference standard for fluid responsiveness. Results: Fluid responsiveness was present in 53.8% of patients according to Delta SVI. LVOTVTI variability (area under the curve [AUC] 0.847, 95% confidence interval [CI]: 0.726-0.968, sensitivity 85.0%, specificity 66.6%) and PPV (AUC 0.832, 95% CI: 0.679-0.985, sensitivity 94.4%, specificity 70.5%) demonstrated the highest predictive accuracy. Carotid flow variability showed moderate performance (AUC 0.754), while dIVC yielded the lowest diagnostic accuracy (AUC 0.676). A strong correlation was observed between bioreactance-derived cardiac index and LVOT-VTI (r=0.835, p<0.001), whereas cCFT was not significantly correlated. Conclusions: Left ventricular outflow velocity-time integral variability demonstrated strong diagnostic accuracy in predicting fluid responsiveness in mechanically ventilated patients with shock when confirmed using bioreactance monitoring. IVC distensibility and carotid flow variability showed limited reliability.
Aim: The aim of this study is to determine whether there is an association between STAT and noninvasive ventilation (NIV) failure, and to describe the factors influencing this outcome in pediatric patients undergoing congenital heart disease (CHD) surgery at a federal referral hospital. Study Design: This analytical cross-sectional study included patients under 18 years of age with CHD who underwent corrective or palliative surgery and required postoperative NIV support between January 2020 and December 2022. The type of ventilation (prophylactic or therapeutic NIV) was determined by the multidisciplinary clinical team based on surgical complexity, hemodynamic stability, and the patient's respiratory status. Continuous quantitative and dichotomous qualitative variables were analyzed using descriptive and inferential statistics (multivariate logistic regression). The R statistical package, version 4.4.1, was used with a 95% confidence level. Results: A total of 110 patients (mean age: 18 months; mean weight: 8 kg) met the inclusion criteria. NIV failure occurred in 21% of cases, predominantly due to respiratory causes. STAT Categories 2, 3, 4, and 5 showed no statistically significant association with NIV failure (p>0.05). Clinical relevance was noted for NIV duration (odds ratio [OR]=1.06), mechanical ventilation duration (OR=1.01), and intensive care unit (ICU) length of stay (OR=1.01). Conclusions: No significant association was found between the STAT Mortality Score and Categories and NIV failure. Although mechanical ventilation duration, NIV duration, and ICU length of stay showed a weak positive association (OR=1.01-1.06), these values indicate minimal clinical impact. These findings suggest that while STAT metrics may assist in patient risk stratification, other postoperative factors play a greater role in predicting NIV failure.
Aim: This study aimed to identify specific antimicrobial agents associated with the development of necrotizing enterocolitis in critically ill neonates and to characterize independent clinical and demographic factors associated with its occurrence in this vulnerable population. Study Design: This retrospective cohort study included neonates admitted for more than 24 hours to a Brazilian neonatal intensive care unit between January 2020 and December 2021. Only cases of necrotizing enterocolitis classified as Bell stage IIA or higher were analyzed. Antimicrobial exposure was assessed by days of therapy, considering only agents administered before the diagnosis of necrotizing enterocolitis. Univariate and multivariate logistic regression analyses were performed. Results: Among 594 neonates included, 15 developed necrotizing enterocolitis (incidence: 1.7%). Meropenem exposure was significantly associated with necrotizing enterocolitis (adjusted odds ratio 3.74; 95% confidence interval: 1.14-12.2; p=0.03). Additional associated factors included lower gestational age, lower birth weight, presence of congenital heart disease, Methicillin-resistant Staphylococcus aureus detection in blood culture, and prolonged hospitalization. No evidence of multicollinearity was found among variables. Conclusions: Meropenem exposure prior to necrotizing enterocolitis onset was associated with a higher likelihood of developing the disease. These findings reinforce the importance of judicious use of broad-spectrum antibiotics and careful monitoring of antimicrobial stewardship in neonatal units.
West Nile virus encephalitis is a neuroinvasive condition with significant diagnostic challenges, especially in immunosuppressed patients. We describe the case of a 54-year-old male patient with a history of kidney transplantation and systemic comorbidities. He presented with fever and altered mental status, and neuroimaging revealed bilateral thalamic lesions and leptomeningeal enhancement. West Nile virus was confirmed via polymerase chain reaction from cerebrospinal fluid. The patient was managed with supportive care and close monitoring. Early recognition and comprehensive diagnostics are crucial for effectively managing high-risk patients, despite the lack of a specific treatment for West Nile virus, as with most other viral diseases.
Aim: Obesity is traditionally associated with increased perioperative risk and complex intensive care unit (ICU) management. However, its prognostic significance in surgical ICU patients remains controversial. This study aimed to evaluate the impact of obesity on postoperative ICU outcomes in patients undergoing elective surgery. Study Design: This retrospective cohort study analyzed adult patients who were intubated and admitted to the ICU after elective surgery between January 1 and December 31, 2023. Patients were classified as non-obese (Body Mass Index [BMI] <30 kg/m(2)) or obese (BMI >= 30 kg/m(2)). Demographic, clinical, and perioperative characteristics were recorded. Primary outcomes included ICU mortality, duration of mechanical ventilation, and ICU length of stay. Hemodynamic parameters and fluid balance were also assessed. Results: A total of 294 patients were included, 57.8% of whom were male. There were no significant differences between obese and non-obese patients in terms of ICU mortality (3.7% overall), mechanical ventilation duration, or ICU length of stay. Hemodynamic stability, including incidence of hypotension and use of vasoactive agents, was similar across groups. Notably, non-obese patients had a significantly higher rate of positive cumulative fluid balance (>= 5%, p=0.003), despite comparable total fluid volumes. Conclusions: Obesity, as defined by BMI, was not associated with increased ICU mortality, prolonged mechanical ventilation, or extended ICU stay following elective surgery. These findings suggest that BMI alone may not be a reliable predictor of adverse postoperative ICU outcomes, highlighting the importance of individualized risk assessment.
Neuroleptic malignant syndrome (NMS) is a rare complication secondary to exposure to a dopamine antagonist or withdrawal of a dopamine agonist. Differential diagnoses of NMS include other conditions associated with increased body temperature such as sepsis, drug withdrawal, thyrotoxicosis, malignant hyperthermia, and serotonin syndrome. Sepsis, as a cause in this setting, has to be ruled out since NMS is a diagnosis of exclusion, which may cause considerable delay. We present a patient who was admitted to the Cardiothoracic Intensive Care Unit after a redo-coronary artery bypass grafting. He was administered two doses of metoclopramide, a dopamine antagonist, for postoperative gastroparesis and as a second-line antiemetic agent. He developed increased body temperature the following day, which did not return to baseline until administration of bromocriptine. The patient was on vasoactive support and invasive ventilation, which impeded the clinical diagnosis of NMS. The only positive features were raised creatine phosphokinase levels and increased body temperature. The patient eventually succumbed to multi-organ failure post-surgery even though NMS was treated. Administration of agents known to potentially cause NMS should always be viewed with suspicion, especially in acute settings where signs and symptoms could be masked. Response to bromocriptine, rise in creatine kinase levels, and persistent increased body temperature may aid in the diagnosis of NMS in a susceptible patient.
Aim: Non-thyroidal illness syndrome (NTIS), characterized by reduced triiodothyronine (T3) levels in the absence of intrinsic thyroid disease, is common among critically ill patients. However, its independent association with intensive care unit (ICU) mortality remains uncertain. This study investigated the association between NTIS and ICU outcomes in adult patients admitted to a tertiary-level medical ICU. Study Design: We retrospectively analyzed adult patients (>= 18 years) admitted to a tertiarylevel medical ICU between May 2021 and May 2023. NTIS was defined as reduced serum T3 with normal or low thyroid-stimulating hormone (TSH) and thyroxine (T4) levels. Patients with known thyroid disease, corticosteroid therapy within the preceding seven days, SARS-CoV-2 <24 hours, or recent radiocontrast exposure were excluded. Demographic, clinical, and laboratory characteristics were compared between patients with and without NTIS. Results: Of 109 patients, 85 (78%) had NTIS. ICU mortality was numerically higher among NTIS patients (30.5%) compared with those without NTIS (16.6%), although the difference was not statistically significant. The NTIS group had higher Sequential Organ Failure Assessment (SOFA) scores (median 8.5 vs. 6; p=0.054) and more frequent need for mechanical ventilation (55.2% vs. 41.6%; p=0.124). No significant differences were observed in ICU length of stay (p=0.17) or hospital mortality (p=0.178). Conclusions: Non-thyroidal illness syndrome was not independently associated with ICU mortality but showed a strong correlation with markers of illness severity. These findings suggest that NTIS may serve as a biomarker of critical illness severity rather than an independent predictor of mortality.
Fever of unknown origin (FUO) presents a diagnostic challenge due to its wide range of possible causes, necessitating comprehensive evaluation. This case report describes the complexities in a 77-year-old male admitted to the intensive care unit (ICU) with persistent fever. Despite thorough investigations and treatment for identified infections, the fever persisted, leading to an uncommon and challenging diagnostic journey. Further evaluation revealed hepatocellular carcinoma (HCC) with unusual presentations, highlighting the complexities of fever management in oncology settings. This case underscores the need for heightened awareness of malignancy-associated FUO and calls for further exploration into atypical manifestations, offering insights into early diagnosis and management strategies.
Aim: This research aimed to explore the correlation between the axillary vein (AXV) and the inferior vena cava (IVC) for volume assessment following non-thoracic abdominal surgery in patients under mechanical ventilation. The primary objective was to determine whether the AXV could serve as a reliable indicator for evaluating volume responsiveness. Study Design: This retrospective cohort study included 106 critically ill patients admitted to the intensive care unit (ICU) of Peking University People's Hospital after non-thoracic abdominal surgery between November 2023 and June 2024. All patients were on invasive mechanical ventilation (volume-controlled; tidal volume 8 mL/kg, positive end-expiratory pressure 5 cmH2O) and had not yet recovered spontaneous respiration postoperatively. The relevant indices were monitored at postoperative admission to the ICU. The diameters of AXV and IVC were measured using ultrasonography, and the dilatation index (DI) was calculated. At admission, ultrasonography was performed on the left ventricle and the left ventricular outflow tract to determine the velocity time index (VTI). These indices were remeasured after a rapid infusion of 100 mL of sodium lactate Ringer's solution. The patients were categorized into volume-responsive and non-volume-responsive groups according to VTI measurements before and after the volume-loading test, and the correlation between the relevant parameters and hypovolemia was analyzed. Results: The sensitivity and specificity of a critical AXV-DI value of 22.2% were 88.1% and 77.36%, respectively. Conclusions: Axillary vein dilatation index is a valid indicator for volume assessment in postoperative patients in surgical ICUs.
Aim: Intensive Care Unit (ICU) readmissions increase mortality and healthcare costs. Identifying high-risk patients is crucial for improving outcomes and optimizing resources. This study aimed to investigate the incidence, risk factors, and outcomes of unplanned readmissions in a medical ICU. Study Design: This retrospective cohort study included adults admitted to the medical ICU of Gazi University between January 2018 and December 2019. Patients who stayed more than 24 hours were analyzed for ICU readmission during the same hospitalization after transfer to general wards or within 48 hours of discharge to home. Demographic, clinical, and laboratory variables were compared between readmitted and non-readmitted patients. Results: Among 477 ICU admissions, 216 patients who died during the initial stay were excluded. Twenty-seven patients (10.3%) experienced unplanned readmission, while 234 comprised the non-readmission group. The overall ICU mortality during the initial admission was 45.3%. Among patients who survived their initial ICU stay, those who were readmitted had a higher ICU mortality rate (74.1%, p=0.028). Compared with the non-readmission group, readmitted patients more frequently had chronic kidney disease (CKD), malnutrition or impaired oral intake, limited mobilization, and pressure ulcers (p<0.05). They also had a higher requirement for noninvasive mechanical ventilation (NIMV) and high-flow nasal cannula therapy during their initial ICU stay (p<0.05). In multivariate analysis, CKD (odds ratio [OR]: 3.38, 95% confidence interval [CI]: 1.03-11.09), malnutrition or impaired oral intake (OR: 5.16, 95% CI: 1.32-20.17), and use of NIMV (OR: 5.08, 95% CI: 1.63-15.90) were independent predictors of ICU readmission. Conclusions: These findings highlight potential targets for risk stratification, warranting validation in larger, multicenter studies.
Melioidosis is a rare and often underrecognized infectious disease caused by the bacterium Burkholderia pseudomallei, which is primarily found in Southeast Asia. This disease can lead to severe systemic complications and carries alarmingly high rates of morbidity and mortality. We present two different case reports of melioidosis: one with disseminated melioidosis and the other presenting as pneumonia. Melioidosis can resemble infections like tuberculosis, complicating diagnosis. Sepsis with multiple abscesses can be associated with Staphylococcal spp. and Klebsiella spp. infection. Bacillus anthracis (anthrax), Francisella tularensis (tularemia), Bartonella henselae (cat scratch disease), and Yersinia pestis (plague) can present with similar symptoms. Fungal infections, particularly those caused by Candida spp., can also present with these symptoms. These case reports highlight the difficulties in identifying disseminated melioidosis and the risks of misdiagnosis, which can lead to inadequate patient management. Increased awareness of melioidosis in endemic areas is essential for improving patient outcomes and public health responses.
Aim: This study investigates the effects of normal versus high-protein intake on malnutrition and anthropometric parameters in critically ill patients receiving enteral nutrition (EN) in the Intensive care unit (ICU) Study Design: Conducted between July and October 2022, this study included 42 patients aged 19-64 years who were receiving EN support. Participants were divided into two groups: 21 patients in the normal-protein group (0.8-1.2 g/kg/day) and 21 patients in the high-protein group (>1.2 g/kg/day). Anthropometric measurements, including upper mid-arm circumference, calf circumference, knee height, body weight, and height, were taken on days 1, 3, 5, and 15. Results: The average age of participants was 47.1 +/- 13.2 years. No significant differences were found between the groups in baseline characteristics (p>0.05). Protein intake was significantly higher in the high-protein group (p<0.05); however, there were no statistically significant differences between groups in changes in upper mid-arm circumference, Body Mass Index (BMI), or Nutritional Risk Screening 2002 (NRS-2002) scores (p>0.05). Within-group comparisons showed significant improvements in both NRS-2002 and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores over time (p<0.05). There were no significant differences in age, gender, marital status, weight, height, or BMI between the two groups (p>0.05). The average weight, height, and BMI across participants were 75.57 +/- 13.97 kg, 171.26 +/- 8.51 cm, and 25.72 +/- 4.26 kg/m2, respectively. Protein intake on Day 1 (90.36 +/- 9.2 g) and Day 15 (90.36 +/- 9.2 g) in the high-protein group was significantly higher than in the normal-protein group (p<0.05). No significant differences were found between groups in terms of knee height, upper mid-arm circumference, or reference percentile values (p>0.05). Conclusions: This study found no significant relationship between protein intake and upper mid-arm circumference, BMI, or NRS-2002 scores. Further research with a larger sample size and longer follow-up period is needed to confirm these findings.
Aim: Malnutrition is a common issue in the intensive care units (ICUs) and can lead to poor clinical outcomes if not managed with adequate nutritional support. This study aimed to examine the association between energy, protein, and micronutrient intake and mortality among malnourished and well-nourished critically ill patients. Study Design: This retrospective cohort study was conducted in a tertiary medical ICU. Patients were enrolled within the first 48 hours of ICU admission and categorized as either wellnourished (modified Nutrition Risk in the Critically Ill [mNUTRIC] score: 0-4) or malnourished (mNUTRIC score: 5-9). Daily energy, protein, and micronutrient intake of adult critically ill patients receiving enteral tube feeding was meticulously monitored during the first seven days in the ICU. Results: A total of 226 patients were included, with 137 classified as malnourished and 89 as well-nourished. The median age of the study population was 65.0 years (range: 47.8-74.0). Patients with malnutrition had lower energy adequacy (%) compared to well-nourished patients (median: 52.3 vs. 68.3, p=0.001). Malnourished patients also received significantly lower amounts of chromium, copper, iodine, iron, manganese, molybdenum, selenium, biotin, vitamin A, vitamin C, and vitamin D compared to well-nourished patients (p<0.05 for all). Multivariate Cox regression analysis revealed that the mNUTRIC score was a significant predictor of ICU Meier analysis demonstrated that malnourished patients had a significantly lower probability of survival compared to well-nourished patients (median (95% CI): 29.0 (16.2-41.8) vs. 17.0 (15.0-19.0) days, p=0.001). Conclusions: Critically ill adult patients with malnutrition had significantly lower energy and selected micronutrient intake via the enteral route, along with a reduced probability of survival.
