Introduction: Traumatic injury accounts for 7% of hospital admissions and places a substantial economic burden on healthcare systems. Longer stays in ICU and hospital contribute to suboptimal nutrition intake and development of iatrogenic complications, and poorer physical recovery. Little is known about the nutrition intakes of patients with critical injury throughout the trajectory of their hospital stay.

Objectives/Aims: To describe protein and energy adequacy among critically injured patients and identify factors that influence intakes in this at-risk group.

Methods: A prospective, single-centre, observational study was conducted using a concurrent mixed methods approach. Quantitative data included protein and energy intakes of patients; qualitative data were collected to identify factors influencing nutrition adequacy. This study was conducted in a metropolitan, tertiary teaching hospital, in southeast Queensland, where approximately 180 patients are admitted with a critical injury each year. Patients were eligible if they were ≥18 years of age and admitted with critical injury requiring ICU admission.

Results: Seventy-nine patients were enrolled; 8 did not transition to an acute care ward because of death or discharge to another facility. Forty-seven (59%) had an Injury Severity Score >15; half required mechanical ventilation. In ICU enteral or oral nutrition was delivered to 22 (28%) and 34 (43%) of patients, respectively. Twenty-three (29%) patients did not receive any nutrition while in ICU. Median energy and protein delivered from EN per day was 5302kJ (IQR 2450-7653) and 50.1g (IQR 24.1-77.6) of protein. After ICU discharge the percentage of energy (%EER) and protein requirements (%EPR) met were low; at day 7 %EER was 52.6% and %EPR was 64.8%. Functional ability and perceptions of nutrition contributed to poor intake after ICU discharge.

Conclusion: Strategies to optimize nutrition intake throughout the critical injury recovery trajectory are important to enhance nutrition intake and support recovery from critical injury.