Associations of energy, protein, and zinc intake adequacy with SOFA scores and length of hospital stay in patients with major burns at Ngoerah General Hospital, Denpasar

Anak Agung Sagung Mirah Prabandari* -  Department of Clinical Nutrition, Faculty of Medicine, Udayana University, Denpasar, Indonesia
Agustinus I Wayan Harimawan -  Department of Clinical Nutrition, Faculty of Medicine, Udayana University, Denpasar, Indonesia
I Wayan Weta -  Department of Clinical Nutrition, Faculty of Medicine, Udayana University, Denpasar, Indonesia
Ni Ketut Sumartini -  Department of Clinical Nutrition, Faculty of Medicine, Udayana University, Denpasar, Indonesia
Syuma Adhy Awan -  Department of Clinical Nutrition, Faculty of Medicine, Udayana University, Denpasar, Indonesia
I Wayan Gede Sutadarma -  Department of Clinical Nutrition, Faculty of Medicine, Udayana University, Denpasar
I Gusti Putu Hendra Sanjaya -  Department of Plastic, Reconstructive, and Aesthetic Surgery, Faculty of Medicine, Udayana University, Denpasar, Indonesia
DOI : 10.30867/action.v11i3.3352

Major burn injuries induce hypermetabolic and hypercatabolic responses that increase nutritional requirements. This retrospective cohort study aimed to evaluate the association between the adequacy of energy, protein, and zinc intake and the Sequential Organ Failure Assessment (SOFA) score and length of hospital stay in patients with major burns. Medical record data were obtained from patients treated at the Burn Unit of the Ngoerah General Hospital, Denpasar, between February 2025 and February 2026. Eligible patients were aged ≥17 years, had burns involving ≥20% of the total body surface area, received enteral nutrition, and were hospitalized for at least three days. Multivariable analyses were performed using negative binomial regression for SOFA scores and a generalized linear model with a gamma distribution and log link for the length of hospital stay. A total of 150 patients were included in the analysis. Energy, protein, and zinc adequacy were achieved by 31.3%, 41.3%, and 90.0% of the patients, respectively. None of the nutritional adequacy measures were independently associated with the length of hospital stay. Protein adequacy (adjusted IRR, 0.196; 95% CI, 0.038–0.999; P = 0.049) and zinc adequacy (adjusted IRR, 0.043; 95% CI, 0.017–0.109; P < .001) were independently associated with lower SOFA scores. In conclusion, adequate protein and zinc intakes were associated with lower SOFA scores; however, causality cannot be inferred from this retrospective study design. Prospective studies with temporally defined nutritional exposure are needed.

Keywords : SOFA score, burns, energy intake, organ dysfunction, protein intake, zinc

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Open Access Copyright (c) 2026 Anak Agung Sagung Mirah Prabandari, Agustinus I Wayan Harimawan, I Wayan Weta, Ni Ketut Sumartini, Syuma Adhy Awan, I Wayan Gede Sutadarma, I Gusti Putu Hendra Sanjaya
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AcTion: Aceh Nutrition Journal
Published by: Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health.
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