PP192 - FROM RISK TO REALITY: INCIDENCE OF REFEEDING SYNDROME AMONG PATIENTS IDENTIFIED BY FRIEDLI CRITERIA

PP192

FROM RISK TO REALITY: INCIDENCE OF REFEEDING SYNDROME AMONG PATIENTS IDENTIFIED BY FRIEDLI CRITERIA

R. Tobberup^1,2,*, M. B. Klausen^1,2

¹Department of Gastroenterology, ²Danish Nutrition Science Center, Aalborg University Hospital, Aalborg, Denmark

Rationale: Refeeding syndrome (RFS) is a serious complication in malnourished patients, but data on progression using Friedli criteria [1] are limited. We quantified imminent and manifest RFS in a retrospective cohort.

Methods: Medical and surgical patients admitted September 2022–October 2025 at risk of refeeding were included; ICU and dialysis patients were excluded. Risk was classified using Friedli criteria [1], and the occurrence of imminent and manifest RFS was determined within each risk group. Association with risk category was assessed using Chi-square. Ethical approval was waived (quality improvement).

Results: Among 447 patients (227 women; mean 68.7±13.1 y), common admissions were “other” (n=223), poor general condition (n=116), nutrition optimization (n=78), infection (n=61), and pain (n=58). Mean weight was 65.0±18.5 kg and BMI 22.7±5.8 kg/m². Friedli risk: low 59 (13.2 %), high 194 (43.4 %), very high 179 (40.0 %). Imminent RFS occurred in 5/59 (8.5 %), 67/194 (34.5 %), 78/179 (43.6 %), respectively. Manifest RFS occured in 8 (1.8 %). Chi-square showed a significant association between risk category and imminent RFS, χ²(2, N=432)=147.66, p<0.001.

Conclusion: Among patients at risk, imminent RFS increased with risk category. Risk strongly predicted progression, highlighting the importance of early identification and close monitoring of patients at high or very high risk.

References:         1. Friedli N, Stanga Z, Culkin A, Crook M, Laviano A, Sobotka L, Kressig RW, Kondrup J, Mueller B, Schuetz P. Management and prevention of refeeding syndrome in medical inpatients: An evidence-based and consensus-supported algorithm. Nutrition. 2018 Mar;47:13-20. doi: 10.1016/j.nut.2017.09.007. Epub 2017 Sep 25. PMID: 29429529.

Disclosure of Interest: None declared