Prevalence, predictive factors, and outcomes of refeeding syndrome among medically critically ill patients: A retrospective cohort study
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Issued Date
2024-01-01
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ISSN
08845336
eISSN
19412452
Scopus ID
2-s2.0-85195948813
Pubmed ID
38864503
Journal Title
Nutrition in Clinical Practice
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SCOPUS
Bibliographic Citation
Nutrition in Clinical Practice (2024)
Suggested Citation
Tongyoo S., Rawangban P., Naorungroj T. Prevalence, predictive factors, and outcomes of refeeding syndrome among medically critically ill patients: A retrospective cohort study. Nutrition in Clinical Practice (2024). doi:10.1002/ncp.11160 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/98911
Title
Prevalence, predictive factors, and outcomes of refeeding syndrome among medically critically ill patients: A retrospective cohort study
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Abstract
Background: Refeeding syndrome (RFS) is a life-threatening metabolic derangement occurring when nutrition is reintroduced after prolonged starvation. Limited data exist regarding RFS prevalence, risk factors, and outcome, particularly in critically ill patients. Methods: A retrospective cohort study was conducted in a medical intensive care unit from June 2018 to August 2020. RFS diagnostic criteria from the National Institute for Health and Care Excellence (NICE) and the American Society for Parenteral and Enteral Nutrition (ASPEN) were used. The primary outcome was 30-day mortality. Results: Among 216 patients, RFS was diagnosed in 22.7% and 27.3% of patients per the NICE and ASPEN criteria, respectively. There was no significant difference in 30-day mortality between patients with and without RFS (22/59 [37.3%] vs 53/157 [33.8%]; P = 0.627). Independent predictors of RFS were malignancy (odds ratio [OR] = 2.09; 95% CI = 1.06–4.15; P = 0.035), septic shock (OR = 2.26; 95% CI = 1.17–4.39; P = 0.016), and high NICE RFS risk classification (OR = 2.52; 95% CI = 1.20–5.31; P = 0.015). Factors associated with reduced RFS risk were Sequential Organ Failure Assessment (SOFA) scores >12 (OR = 0.45; 95% CI = 0.23–0.88; P = 0.020) and high-dose vasopressor treatment (OR = 0.34; 95% CI = 0.14–0.79; P = 0.012). Conclusion: RFS affected one-fourth of the critically ill patients but did not significantly impact 30-day mortality. Malignancy, septic shock, and high NICE RFS risk classification were positively associated with RFS, whereas high SOFA scores and extensive vasopressor use were linked to decreased risk.