Association between Dietary Intake and Nutritional status of Critically Ill Non-Invasive Ventilated Adult Patients in Malindi Referral Hospital, Kilifi County, Kenya

Résumé

Background: Malnutrition among critically ill non-invasive ventilated adult patients is a significant concern, particularly in resource-limited settings such as Malindi Sub-County Referral Hospital, Kilifi County, Kenya. This study determines the association between dietary intake and nutritional status among these patients. Dietary intake adversely influences nutrition status outcomes. Materials and Methods: A cross-sectional, with an analytical component, study was conducted between July 2023 and May 2024 at Malindi Sub-County Referral Hospital. The study included 108 critically ill adult patients on non-invasive ventilation between 24 to 48 hours of admission, but only 103 were included in the final analysis. Five participants experienced acute complications, requiring transfer to intensive care for invasive ventilation. Participants were selected using the two-step purposive sampling. The first step was selecting all critically ill adult patients for study consideration. Step two was selecting all critically ill Non-invasive ventilated adult patients for inclusion in the study. The data was collected using a structured questionnaire with a component of 24 24-hour recall tool for dietary intake assessments. Descriptive and inferential statistical analyses were performed using SPSS 23.0. Results: The study found that 66% of the participants were severely malnourished (BMI < 18.5 kg/m²). The average calorie intake was 950 ± 471.8 Kcal, and 88.3% of participants consumed less than or equal to 15 grams of protein daily. There was a significant association between low dietary intake and malnutrition, with malnourished patients consuming fewer calories (M = 918.37 Kcal) and protein (M = 10.50 g) compared to their non-malnourished counterparts. Patients receiving specialized enteral diets or with a recommendation for nil per oral were significantly more likely to be classified as malnourished based on their SGA status (specialized enteral diets: OR = 6.852, χ² = 4.298, p = 0.036; nil per oral: OR = 2.161, χ² = 8.070, p = 0.005), indicating a strong link between these interventions and the risk of malnutrition. Conclusion: The study highlights a high prevalence of malnutrition among critically ill non-invasive ventilated adult patients, primarily due to suboptimal caloric and protein intake. Optimal nutritional interventions are necessary to enhance the dietary intake and overall nutritional status of these patients.