Assessing energy expenditure: Accuracy of predictive equations versus indirect calorimetry in older hospitalized patients at the medical ward

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BACKGROUND & AIMS: Indirect calorimetry (IC) is considered the gold standard to measure Resting Energy Expenditure (REE) in clinical practice. However, this method is more time-consuming than using estimates. Therefore, this study aimed to determine 1) the accuracy between estimated and measured energy requirement and 2) if certain patient characteristics were associated with discrepancies between measured and estimated energy requirement. METHODS: The patient's measured REE was assessed with IC. To determine Total Energy Expenditure (TEE), an individual level of activity was applied. The measured REE and TEE were compared with the Harris-Benedict (H-B) equation and measured TEE with two weight-based formulas. A variation of ±10 % was regarded as an acceptable value of variation. To explore whether specific variables were related to differences between measurements and estimates, the following variables were recorded: age, Body Mass Index (BMI), body temperature, heart rate, Mean Arterial Pressure (MAP), respiratory rate, p-C-Reactive Protein (p-CRP), B-Leucocytes, and p-Albumin. RESULTS: = 0.170) of the variation could be explained by these variables. CONCLUSION: The H-B equation was most accurate at predicting energy expenditure, however, only in alignment with IC measurements in about half of the patients. Several infectious markers were associated with an increase in REE compared with estimated by the H-B equation.

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