P069 - INCIDENCE AND RISK FACTORS OF REFEEDING SYNDROME IN INPATIENTS UNDERGOING ENTERAL AND PARENTERAL NUTRITION

P069

INCIDENCE AND RISK FACTORS OF REFEEDING SYNDROME IN INPATIENTS UNDERGOING ENTERAL AND PARENTERAL NUTRITION

R. O. Rocha^1,* on behalf of Rezende MS, Oliveira HG, Chini LSN, Matos JPS

¹Internal Medicine, UFF, Niteroi, Brazil

Rationale: Refeeding syndrome (RS) comprises electrolytes and metabolic disturbances that occur after the reintroduction of feeding in patients with prolonged fasting. The incidence is variable (1) We aimed to evaluate the incidence and the risk factors for RS in inpatients from a school hospital in Brazil, who received enteral (EN) and parenteral nutrition (PN). 

Methods: A retrospective study, including patients who received EN and PN after at least a 3-day fasting period. RS diagnosis was based on P, K, and Mg change in the first 3 days after diet reintroduction (2). Clinical, anthropometric, laboratory evaluations, caloric prescriptions, were also collected. Risk factors for RS development were evaluated using logistic regression, and the 30-day mortality risk was analyzed using Cox regression.

Results: From 797 patients who received EN and PN, 315 were included in the final analysis. The median age was 65 (IQR 56 - 73) years, 55% were men, 45% had cancer, and BMI was 23.7 Kg/m². Development of RS was found in 36.8% of patients (77%) due to a phosphate reduction >30% after refeeding started. The risks associated with RS development were female gender and higher serum sodium levels. The 30-day survival rates for patients with or without RS were 50.7% and 49.9%, respectively (p = 0.42). In the Cox regression model, the diagnosis of RS was not associated with death risk.

Conclusion: A high incidence of RS was found, but was not associated with increased death risk. The absence of an increased risk of death following RS development could be explained by the prompt diagnosis and treatment of electrolyte disorders.

References:  

1-  Da Silva JSV et als. ASPEN Consensus Recommendations for Refeeding Syndrome. Nutr Clin Pract 2020; 35(2):178-195

2- Friedli NF et als. Management and prevention of refeeding syndrome in medical inpatients : an evidence-based and consensus-supported algorithm. Nutrition 2018 ;(47) :13-20

Disclosure of Interest: None declared