Abstract
This study investigated the relationship between protein and energy intake during the early (days 1-2) and late (days 3-7) acute phase and prognosis in septic patients with nutritional risk screening 2002 ≥ 3. Cox regression analysis was performed to identify factors associated with 28-day mortality. Among 293 shock patients, higher energy intake in days 3-7 was signifcantly associated with lower 28-day mortality (hazard ratio, 0.969; 95% confidence interval, 0.942-0.997; P = 0.033). Kaplan-Meier analysis showed achieving 75% of energy target in days 3-7 correlated with decreased 28-day mortality (P = 0.040). In 309 non-shock patients, no significant relationships between nutritional therapy during acute phase and 28-day mortality were observed. Enhanced energy intake in days 3-7 showed no correlation with improvements in length of intensive care unit/hospital stay, ventilator-free days, non-ICU survival days or hospitalization costs for septic patients. In shock patients, energy intake in days 3-7 demonstrated no relationship with secondary infections; however, among non-shock patients, achieving 50% of energy intake in days 3-7 was linked to lower incidence of fungus infections (P = 0.006) and intra-abdominal infections(P = 0.003). Our findings demonstrate statistical associations between augmenting energy intake during the late acute phase and potential benefits in sepsis.