Background
Estimation of resting energy expenditure (REE) is essential in planning nutrition
support. Several equations are used for this estimation in the clinical setting. The
purpose of this study was to compare the predictive accuracy of existing equations
for REE in patients with cerebral infarct during acute care.
Methods
We assessed the Harris–Benedict, Mifflin, Owen, Japanese simplified, Wang, and Cunningham
equations. The Owen and Japanese simplified equations use sex and weight as explanatory
variables, the Harris–Benedict and Mifflin equations include sex, weight, age, and
height, and the Wang and Cunningham equations use fat-free mass (FFM) measured using
bioelectrical impedance technology. Actual REE values were measured by indirect calorimetry
on days 2 and 7 and were then averaged. Applying analysis of variance, predictive
accuracy was assessed by comparing the predicted and actual values.
Results
A total of 30 patients were analyzed. Actual REE values ranged from 796 to 1637 kcal
(mean, 1109). The standard deviation of these values was the smallest with the Harris–Benedict
equation (99), followed by the Cunningham (165), and Wang (181) equations. The Mifflin
equation underestimated REE in females, whereas the Owen and Japanese simplified equations
tended to overestimate it.
Conclusions
Based on our results, the Harris–Benedict equation provides the most accurate prediction
of REE. In addition, the Cunningham and Wang equations may be useful in long-term
care settings involving patients at risk of malnutrition resulting in uneven loss
of FFM relative to weight.
Key Words
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Article info
Publication history
Published online: May 19, 2015
Accepted:
April 21,
2015
Received in revised form:
April 16,
2015
Received:
March 28,
2015
Footnotes
This study was supported in part by a Grand-in-Aid for Scientific Research (B), the Japan Society for the Promotion of Science (KAKENHI [25282168]), and the Medical Research Fund of Hyogo Medical Association (MRF-H-10-14).
The authors declare that they have no conflicts of interest.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.04.029
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
