The impact of enteral feeding intolerance on the prognosis of patients with septic shock in South Korea

Background While enteral feeding intolerance (EFI) is associated with worse clinical outcomes in critically ill patients, the relationship between the number of days of EFI and mortality outcomes remains unclear. Methods We retrospectively analyzed adult patients admitted to the medical intensive ca...

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Main Authors: Hyun-Jun Park, Yoon Hae Ahn, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee
Format: Article
Language:English
Published: Korean Society of Critical Care Medicine 2025-05-01
Series:Acute and Critical Care
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Online Access:http://accjournal.org/upload/pdf/acc-000700.pdf
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author Hyun-Jun Park
Yoon Hae Ahn
Hong Yeul Lee
Sang-Min Lee
Jinwoo Lee
author_facet Hyun-Jun Park
Yoon Hae Ahn
Hong Yeul Lee
Sang-Min Lee
Jinwoo Lee
author_sort Hyun-Jun Park
collection DOAJ
description Background While enteral feeding intolerance (EFI) is associated with worse clinical outcomes in critically ill patients, the relationship between the number of days of EFI and mortality outcomes remains unclear. Methods We retrospectively analyzed adult patients admitted to the medical intensive care unit (ICU) with septic shock at a tertiary referral center. EFI was defined as the presence of vomiting, abdominal distension, pain, diarrhea, or radiographic evidence of ileus. EFI status was assessed daily, and we evaluated the prognostic impact of total number of EFI days during the first 3 days of enteral feeding on clinical outcomes. Results A total of 94 patients were included in the analysis, with 77 (81.9%) experiencing EFI. During the first 3 days of enteral feeding, 25 patients (26.6%) experienced EFI for 1 day, 22 patients (23.4%) experienced EFI for 2 days, and 30 patients (31.9%) experienced EFI for all 3 days. The total number of EFI days was identified as an independent risk factor of 90-day mortality (adjusted hazard ratio, 1.400; 95% CI, 1.021–1.919). Higher total EFI days was significantly associated with increased ICU mortality (P for trend=0.036), in-hospital mortality (P for trend=0.007), 30-day mortality (P for trend=0.004), and 90-day mortality (P for trend=0.006). Conclusions An increase in the total number of EFI days was significantly associated with mortality outcomes in patients with septic shock, suggesting that EFI may serve as a useful indicator for predicting outcomes in this population.
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spelling doaj-art-2cd9e0baa8dc4dea90125b455eec9b632025-08-20T02:37:06ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602025-05-0140230431210.4266/acc.0007001604The impact of enteral feeding intolerance on the prognosis of patients with septic shock in South KoreaHyun-Jun Park0Yoon Hae Ahn1Hong Yeul Lee2Sang-Min Lee3Jinwoo Lee4 Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Korea Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Korea Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Korea Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, KoreaBackground While enteral feeding intolerance (EFI) is associated with worse clinical outcomes in critically ill patients, the relationship between the number of days of EFI and mortality outcomes remains unclear. Methods We retrospectively analyzed adult patients admitted to the medical intensive care unit (ICU) with septic shock at a tertiary referral center. EFI was defined as the presence of vomiting, abdominal distension, pain, diarrhea, or radiographic evidence of ileus. EFI status was assessed daily, and we evaluated the prognostic impact of total number of EFI days during the first 3 days of enteral feeding on clinical outcomes. Results A total of 94 patients were included in the analysis, with 77 (81.9%) experiencing EFI. During the first 3 days of enteral feeding, 25 patients (26.6%) experienced EFI for 1 day, 22 patients (23.4%) experienced EFI for 2 days, and 30 patients (31.9%) experienced EFI for all 3 days. The total number of EFI days was identified as an independent risk factor of 90-day mortality (adjusted hazard ratio, 1.400; 95% CI, 1.021–1.919). Higher total EFI days was significantly associated with increased ICU mortality (P for trend=0.036), in-hospital mortality (P for trend=0.007), 30-day mortality (P for trend=0.004), and 90-day mortality (P for trend=0.006). Conclusions An increase in the total number of EFI days was significantly associated with mortality outcomes in patients with septic shock, suggesting that EFI may serve as a useful indicator for predicting outcomes in this population.http://accjournal.org/upload/pdf/acc-000700.pdfenteral nutritionintensive care unitsmortalityseptic shock
spellingShingle Hyun-Jun Park
Yoon Hae Ahn
Hong Yeul Lee
Sang-Min Lee
Jinwoo Lee
The impact of enteral feeding intolerance on the prognosis of patients with septic shock in South Korea
Acute and Critical Care
enteral nutrition
intensive care units
mortality
septic shock
title The impact of enteral feeding intolerance on the prognosis of patients with septic shock in South Korea
title_full The impact of enteral feeding intolerance on the prognosis of patients with septic shock in South Korea
title_fullStr The impact of enteral feeding intolerance on the prognosis of patients with septic shock in South Korea
title_full_unstemmed The impact of enteral feeding intolerance on the prognosis of patients with septic shock in South Korea
title_short The impact of enteral feeding intolerance on the prognosis of patients with septic shock in South Korea
title_sort impact of enteral feeding intolerance on the prognosis of patients with septic shock in south korea
topic enteral nutrition
intensive care units
mortality
septic shock
url http://accjournal.org/upload/pdf/acc-000700.pdf
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