Is there a relationship between nutritional goal achievement and pressure injury risk in intensive care unit patients receiving enteral nutrition?

Objectives: To assess pressure injury risk and time until pressure injury development according to the achievement of nutritional goals, i.e. caloric and protein intake within the first 72 hours of the intensive care admission. Method: Prospective observational cohort study conducted in two units at a public university hospital. The development of pressure injury was considered the dependent variable. Survival curves were prepared with the Kaplan Meier method. Univariate and multivariate Cox regression analysis was used to identify factors associated with the development of pressure injury. Results: The study sample included 181 patients, of which 56.4% were male and the average age was 55 years. Neurological pathologies were the most frequent cause of hospitalisation (44.8%). The average length of stay was 17.5 days and mortality 30.4%. With regards to nutritional goals, 105 patients (58.0%) achieved their caloric goal, 130 (71.8%) achieved protein goals, and 98 (54.1%) achieved both. The frequency of pressure injury occurrence was 31.5%. Caloric intake (hazard ratio [HR] 2.3, 95% confidence interval [CI] 1.24-4.36) and protein intake (HR 3.21, 95% CI 1.76-5.86), were identified as independently associated with pressure injury development. Higher Braden scores were identified as a protective factor (HR 0.65, 95% CI 0.56-0.77). Conclusions: These results indicate that the time to pressure injury development in the group of patients who did not achieve nutritional goals was shorter compared to those who achieved nutritional goals. Further studies should be conducted to confirm these data and to study the relationships in greater detail. (C) 2020 Elsevier Ltd. All rights reserved.