97 PROTEIN AND ENERGY INTAKE DURING ICU-RECOVERY 6 clinical characteristics are presented for the total study population. Between- group differences were tested with a Mann-Whitney U test or Chi-square test, when appropriate. A nested Kruskal-Wallis test was used to assess group differences of average daily protein intake over the first 7 days of ICU-admission. Dunn’s multiple comparisons post-hoc testing was used to compare 1) EN/PN feeding routes with 2) EN/PN + OD, and 3) OD without supplementation. Spearman’s rank correlation coefficients were calculated to assess the direction (positive or negative) of the relationship between protein intake, baseline characteristics, nutritional strategies, paramedic support, nutritional barriers and long-term outcomes. Data were visualised using GraphPad Prism version 9 for Windows (Graphpad Software). All statistical analyses were conducted using SPSS Statistics for Windows, Version 27 (IBM). 6.3 RESULTS 6.3.1 Baseline and clinical characteristics In total, 107 patientswere found to be eligible to participate after initial screening. Of these patients, 16 were excluded due to mortality before ICU-discharge and six patients with an expected LOS of more than 48 hours were discharged within the first two days. Four patients declined participation during the informed consent procedure. Eighty-one patients participated in the follow-up period and were subsequently included in this study. The majority of patients were male (68%) with a median age of 69 [60-76] years. According to the CFS 28% was pre-frail at ICU-admission and all patients were severely ill (APACHE III: 76 [57-99]) (Table 2). Out of 81 patients, five (6%) did not survive until the end of the study period. Thirty-five patients (43%) were readmitted to the medical centre at least once during follow-up. In addition, seven patients (8%) were readmitted to the ICU at least once during the year. 6.3.2 Protein and energy intake during and after ICU During and after ICU-admission, the majority of patients did not reach the minimum protein or advised average energy targets (Figure 1, Supplemental table 2 for absolute values and valid percentages). At day seven in the ICU, 32 patients (out of 36 still admitted) did not reach 1.2 g/kg protein intake and 30 of them received less than 25 kcal/kg. In the post-ICU recovery period, median protein intake remained below the minimal intake target of 1.2 g/kg/d at all time points. After 12-months of recovery, six out of 60 patients managed to achieve protein adequacy and 17 patients reached the advised energy target. Overall, 34%, 23%, and 38% of the population had a protein intake of < 0.8 g/kg/d at 3, 6
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