Ruiqi Xiong1, Hua Huang2, Yongming Wu1, Shengnan Wang1, Dongmei Wang1, Zhong Ji1, Zhenzhou Lin1, Nailiang Zang1, Suyue Pan3, Kaibin Huang4. 1. Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China. 2. Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Neurology, Shenzhen People's Hospital, Southern Medical University, Guangzhou, China. 3. Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address: pansuyue@smu.edu.cn. 4. Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address: hkb@smu.edu.cn.
Abstract
BACKGROUND & AIM: Neurocritically ill patients are more likely to be comatose and suffer from dysphagia, conditions that inevitably require nutritional support. Inappropriate nutritional support may lead to refeeding syndrome (RFS). This study aimed to explore the incidence and outcome of RFS in neurocritically ill patients. METHODS: We conducted a retrospective study among neurocritically ill patients who received total enteral nutrition for >72 h in a university-affiliated hospital. RFS was defined as the occurrence of new-onset hypophosphatemia (<0.65 mmol/L) within 72 h of the commencement of nutritional support. The primary outcome was 6-month mortality. The secondary outcomes included 30-day mortality, neurocritical care unit (NCU) stay, and hospital length of stay. RESULTS: A total of 328 patients were enrolled, and 56 (17.1%) of them developed RFS within 72 h of nutrition support. Significantly, we found that patients with high malnutrition universal screening tool (MUST) and sequential organ failure assessment (SOFA) scores were more likely to develop RFS. The occurrence of RFS was associated with a longer NCU stay, higher 30-day mortality and 6-month mortality, and poorer 6-month functional outcome. Moreover, RFS was identified as an independent risk factor for 6-month mortality. CONCLUSION: RFS is not rare in neurocritically ill patients and is more likely to occur in patients with nutritional risk and more severe conditions. RFS is an independent risk factor for 6-month mortality in neurocritically ill patients.
BACKGROUND & AIM: Neurocritically illpatients are more likely to be comatose and suffer from dysphagia, conditions that inevitably require nutritional support. Inappropriate nutritional support may lead to refeeding syndrome (RFS). This study aimed to explore the incidence and outcome of RFS in neurocritically illpatients. METHODS: We conducted a retrospective study among neurocritically illpatients who received total enteral nutrition for >72 h in a university-affiliated hospital. RFS was defined as the occurrence of new-onset hypophosphatemia (<0.65 mmol/L) within 72 h of the commencement of nutritional support. The primary outcome was 6-month mortality. The secondary outcomes included 30-day mortality, neurocritical care unit (NCU) stay, and hospital length of stay. RESULTS: A total of 328 patients were enrolled, and 56 (17.1%) of them developed RFS within 72 h of nutrition support. Significantly, we found that patients with high malnutrition universal screening tool (MUST) and sequential organ failure assessment (SOFA) scores were more likely to develop RFS. The occurrence of RFS was associated with a longer NCU stay, higher 30-day mortality and 6-month mortality, and poorer 6-month functional outcome. Moreover, RFS was identified as an independent risk factor for 6-month mortality. CONCLUSION:RFS is not rare in neurocritically illpatients and is more likely to occur in patients with nutritional risk and more severe conditions. RFS is an independent risk factor for 6-month mortality in neurocritically illpatients.