Are nutritional sufficiency of ≥75% energy and protein requirements relevant targets in patients at nutritional risk? - A one month follow-up study

Sabina Mikkelsen*, Karen Hougaard Frost, Emma Mølgaard Engelbreth, Lærke Nilsson, Karen Marie Peilicke, Randi Tobberup, Lotte Boa Skadhauge, Henrik Højgaard Rasmussen, Mette Holst

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Background & aim: Nutrient intake in patients at nutritional risk was recorded with the aim of reaching at least 75% of estimated requirements for energy and protein. However, the cutoff at 75% has only been sparsely investigated. The aim of this study was to re-evaluate the 75% cutoff of estimated energy and protein requirements among patients at or not at nutritional risk in relation to 30-day mortality and readmissions. Methods: A 30-day follow-up study was performed among hospitalized patients in 31 units at a Danish University Hospital. Data was collected using the nurses’ quartile nutrition registration method and electronic patient journals. All patients were screened using the NRS-2002 and classified as either at nutritional risk (NRS-2002, score ≥3) or not at nutritional risk (NRS-2002, score <3). Energy and protein requirements were estimated using weighted Harris–Benedict equation and 1.3 g/kg/day, respectively. Results: In total, 318 patients were included in this study. Patients at nutritional risk were older, lower BMI, male, more comorbidities and a longer primary length of stay compared to patients not at nutritional risk (p < 0.05). After 30-day follow-up, mortality was higher among patients at risk (9.5% vs. 2.0%, p < 0.05). Patients at nutritional risk showed increased risk of mortality if they did not achieve 75% of estimated requirements (energy: OR = 8.08 [1.78; 36.79]; protein: OR = 3.40 [0.74; 15:53]). Furthermore, predicted probability of mortality decreased with increased energy and protein intakes. No significant associations were found for readmissions achieving 75% of estimated energy or protein requirements. A cutoff of 76–81% for energy and 58–62% for protein was equivalent with accepting a 6–8% mortality rate. Conclusion: The results of this study indicate that an energy intake ≥75% of estimated requirement among patients at nutritional risk has a preventative effect regarding mortality within one month, but not for readmissions.

Original languageEnglish
JournalClinical Nutrition ESPEN
Pages (from-to)398-405
Number of pages8
Publication statusPublished - Apr 2023

Bibliographical note

Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.


  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Inpatients
  • Male
  • Malnutrition/etiology
  • Nutritional Status
  • Protein requirement
  • Mortality
  • Hospitalized patients
  • Energy requirement
  • Malnutrition
  • Readmissions


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