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. 2025 Sep 18;17(18):2995.
doi: 10.3390/nu17182995.

"V体育官网入口" Impact of Dietitian-Guided Individualized Nutrition (DGIN) on ICU Outcomes in Critically Ill Patients: A Retrospective Cohort Study in Taiwan

Shih-Ching Lo  1   2   3 , Hsing-Chun Lin  2   3 , Yu-Hsun Wang  4 , Ying-Ru Chen  2 , Shun-Fa Yang  1   4
Affiliations

Impact of Dietitian-Guided Individualized Nutrition (DGIN) on ICU Outcomes in Critically Ill Patients: A Retrospective Cohort Study in Taiwan

"V体育安卓版" Shih-Ching Lo et al. Nutrients. .

Abstract (VSports最新版本)

Background: On 1 October 2019, the Taiwan National Health Insurance (NHI) Administration introduced reimbursement for nutritional care services provided to intensive care unit (ICU) patients, under the category of nutritional care fees. These services included the implementation of structured, dietitian-guided individualized nutrition (DGIN) protocols designed to address the clinical needs of critically ill patients VSports手机版. Objectives: This study aimed to evaluate the effectiveness of DGIN in critically ill patients following the implementation of NHI coverage. Methods: This retrospective cohort study was conducted in the ICU of a tertiary medical center, including patients admitted between 1 September 2018 and 31 October 2020, encompassing periods both before and after the initiation of NHI coverage. Under NHI coverage, dietitian-guided individualized nutritional support was provided within the first two weeks of admission. The intervention group received DGIN within the first two weeks of ICU admission. A total of 5292 patients were screened; 2381 were included in the final analysis (1116 in the standard care (SC) group and 1265 in the DGIN group), categorized based on the timing of NHI coverage and the corresponding frequency of dietitian visits. The DGIN protocol comprised a baseline assessment within 24-48 h and three structured reviews during the first ICU week, while the comparator received SC. Demographic characteristics, daily nutritional data, and clinical outcomes were analyzed. Results: Significant baseline differences in nutritional intake and disease severity were observed. Following the introduction of the DGIN protocol, the intervention group received more structured and closely monitored nutrition management, which resulted in less aggressive caloric intake. This approach was associated with a significantly shorter ICU length of stay (SC: 8. 1 ± 6. 7 days vs. DGIN: 7. 1 ± 7. 4 days, p < 0. 001). Conclusions: An ICU nutritional care plan involving frequent assessments and timely interventions by clinical dietitians is associated with a reduced ICU length of stay in critically ill patients. These findings support the effectiveness of integrating dietitian-led nutritional care into national health insurance coverage for ICU patients. .

Keywords: clinical outcomes; critical care; dietitian-guided individualized nutrition; dietitians; length of stay; nutrition support V体育安卓版. .

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Conflict of interest statement

The authors declare no conflicts of interest V体育ios版. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of cohort selection and analysis sets. Among 5292 intensive care unit (ICU) admissions between September 2018 and October 2020, 2911 were excluded (for reasons detailed in the flowchart), yielding a cohort of 2381 patients stratified into the dietitian-guided individualized nutrition (DGIN) group (n = 1265) and the standard care (SC) group (n = 1116). A 1:1 propensity score–matched subset was created for sensitivity analysis (n = 968 per group). Abbreviations: DGIN, dietitian-guided individualized nutrition; SC, standard care; ICU, intensive care unit.
Figure 2
Figure 2
Comparison of the dietitian-guided individualized nutrition (DGIN) protocol and the standard care (SC) cadence for nutritional support. The timeline illustrates two proactive nutritional care models across three clinical phases of the intensive care unit (ICU) stay. The DGIN protocol (top panel) represents an intensified, structured approach. It includes an initial assessment within 48 h of admission and a high-frequency schedule of subsequent reviews during the late acute (days 2–7) and recovery (days 7–14) phases, with built-in cadence checkpoints to ensure a minimum contact frequency. The SC pathway (bottom panel) represents the standard institutional cadence, consisting of an initial visit within one working day followed by routine documentation every three working days. Markers denote scheduled DGIN assessments (circles), DGIN cadence checkpoints (diamonds), and SC visits (triangles).
Figure 3
Figure 3
(A) Boxplot comparing ICU length of stay (LOS) between the SC and DGIN groups. The DGIN group had a significantly shorter ICU LOS (p < 0.001). (B) Kaplan–Meier survival curves showing no significant difference in survival probability between the groups (log-rank p = 0.124).
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