Appetite during the recovery phase of critical illness: a cohort study

Background/Objectives: Reduced appetite is a recognised physiological symptom in survivors of critical illness. Whilst reduced appetite has been reported by patients after ICU, quantification using visual analogue scales has not been previously performed, and follow-up duration has been limited. We aimed to describe appetite scores in ICU survivors during the first three months post ICU discharge and explore association with systemic inflammation. Subjects/Methods: Secondary analysis of data collected in a complex rehabilitation intervention trial (RECOVER). A subgroup of 193 patients provided specific consent for inclusion in the blood sampling sub-study during consent for the main study. We studied appetite using a visual analogue scale (VAS); serum C-reactive protein (CRP); interleukin 1β and 6 (IL-1β and IL-6); and hand-grip strength (HGS). Results: Median (IQR) score on 0-10 appetite visual analogue scale was 4.3 (2.0-6.5) 1 week after ICU discharge, improving to 7.1 (4.6-8.9) by 3 months (mean difference 1.7 (0.9-2.4) p<0.01). Number of days spent in an acute hospital following an intensive care stay was associated with poorer appetite scores (p=0.03). CRP concentration and appetite were significantly associated at 1 week after ICU discharge (p=0.01), but not at 3 months after ICU discharge (p=0.67). Conclusions: ICU survivors experience reduced appetite during the acute recovery phase of critical illness that could impact on nutritional recovery and this was associated with CRP concentration 1 week after ICU discharge.