Elsevier

Nutrition

Volume 14, Issue 3, March 1998, Pages 319-321
Nutrition

Original Articles
Outcome From Nutritional Support Using Hospital Food 1

https://doi.org/10.1016/S0899-9007(97)00481-4Get rights and content

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Treatment Plan and Dietary Goals

In designing a treatment plan for the patients at special risk, energy requirements were calculated by the factorial method,[3]based on the calculation for healthy subjects.[4]This approach has been evaluated in hospitalized patients with liver cirrhosis.5, 6Basal metabolic rate (BMR) was estimated from Harris-Benedict equations and multiplied by a diurnal activity factor (AF). Typical values for healthy subjects are 1.4 to 1.6, for ambulatory patients 1.2 to 1.3, and for bedridden patients

Outcome Measures

After completion of the period of nutritional support, total energy intake and expenditure for the patient is calculated from the records described above. Expected weight change is calculated from the difference between energy intake and energy expenditure for weight maintenance, and compared with the actual change in weight measured. The energy equivalent of weight gain or loss is calculated from the observed energy balance according to initial body weight.8, 9At an initial body weight of 60

Results

Of the 1 115 patients requiring special nutritional support, 123 could not be included in the analysis because they were transferred to other hospitals within 1 wk. The results for the other 977 patients are presented in Table I and Fig. 1. The average duration of nutritional therapy in these patients was 4.5 ± 0.1 wk, reflecting the severity of underlying disease. The average age of the patients was 46.0 ± 0.5 y. In 87 patients, nutritional support was stopped because the patient died. In all

Summary and Conclusions

From the results in the 733 patients without initial edema, we can make predictions for the nutritional requirements of the average hospital patient: BMR by Harris-Benedict 5.9 MJ/d (1 410 kcal/d); average activity factor 1.15, average stress factor 1.02, giving a basic requirement of 1.17 × BMR. However, the shortfall between expected weight gain and observed weight gain, which gives an average empiric disease factor of 1.1, suggests that a Fig. 1 of 1.3 × BMR is a more appropriate target. If,

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Guest Editors: Anne Coble Voss, PHD, RD Manager, Outcomes Research, Ross Products Division, Columbus, Ohio, USA. Simon Allison, MD, FRCP, Consultant Physician, Department of Medicine, Queens Medical Centre, Nottingham, United Kingdom.

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