Early administration of protein in critically ill patients: A retrospective cohort study

Itai Bendavid*, Oren Zusman, Ilya Kagan, Miriam Theilla, Jonathan Cohen, Pierre Singer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


It is currently uncertain whether early administration of protein improves patient outcomes. We examined mortality rates of critically ill patients receiving early compared to late protein administration. This was a retrospective cohort study of mixed ICU patients receiving enteral or parenteral nutritional support. Patients receiving >0.7 g/kg/d protein within the first 3 days were considered the early protein group and those receiving less were considered the late protein group. The latter were subdivided into late-low group (LL) who received a low protein intake (<0.7 g/kg/d) throughout their stay and the late-high group (LH) who received higher doses (>0.7 g/kg/d) of protein following their first 3 days of admission. The outcome measure was all-cause mortality 60 days after admission. Of the 2253 patients included in the study, 371 (36%) in the early group, and 517 (43%) in the late-high group had died (p < 0.001 for difference). In multivariable Cox regression analysis, while controlling for confounders, early protein administration was associated with increased survival (HR 0.83, 95% CI 0.71–0.97, p = 0.017). Administration of protein early in the course of critical illness appears to be associated with improved survival in a mixed ICU population, even after adjusting for confounding variables.

Original languageEnglish
Article number106
Issue number1
StatePublished - Jan 2019


  • Critically ill
  • Early
  • Mortality
  • Nutrition
  • Protein


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