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).
CONCLUSIONS: 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.
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).
CONCLUSIONS: 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.
摘要：
背景：再摄食综合征（RFS）是一种威胁生命的代谢紊乱，在长期饥饿后重新引入营养时发生。关于RFS患病率的数据有限，危险因素，和结果，尤其是危重病人。
方法：一项回顾性队列研究于2018年6月至2020年8月在医疗重症监护病房进行。使用了美国国家健康与护理卓越研究所（NICE）和美国肠外和肠内营养学会（ASPEN）的RFS诊断标准。主要结果是30天死亡率。
结果：在216名患者中，根据NICE和ASPEN标准，RFS诊断为22.7%和27.3%的患者，分别。有和没有RFS的患者30天死亡率没有显着差异（22/59[37.3%]vs53/157[33.8%]；P=0.627）。RFS的独立预测因素是恶性肿瘤（比值比[OR]=2.09;95％CI=1.06-4.15;P=0.035），感染性休克(OR=2.26;95%CI=1.17-4.39;P=0.016),高NICERFS风险分级(OR=2.52;95%CI=1.20-5.31;P=0.015)。与RFS风险降低相关的因素是序贯器官衰竭评估（SOFA）评分>12（OR=0.45；95％CI=0.23-0.88；P=0.020）和大剂量血管加压药治疗（OR=0.34；95％CI=0.14-0.79；P=0.012）。
结论：RFS影响了四分之一的危重患者，但对30天死亡率没有显著影响。恶性肿瘤,感染性休克,高NICERFS风险分级与RFS呈正相关，而高SOFA评分和广泛使用血管加压药与风险降低相关.
方法：一项回顾性队列研究于2018年6月至2020年8月在医疗重症监护病房进行。使用了美国国家健康与护理卓越研究所（NICE）和美国肠外和肠内营养学会（ASPEN）的RFS诊断标准。主要结果是30天死亡率。
结果：在216名患者中，根据NICE和ASPEN标准，RFS诊断为22.7%和27.3%的患者，分别。有和没有RFS的患者30天死亡率没有显着差异（22/59[37.3%]vs53/157[33.8%]；P=0.627）。RFS的独立预测因素是恶性肿瘤（比值比[OR]=2.09;95％CI=1.06-4.15;P=0.035），感染性休克(OR=2.26;95%CI=1.17-4.39;P=0.016),高NICERFS风险分级(OR=2.52;95%CI=1.20-5.31;P=0.015)。与RFS风险降低相关的因素是序贯器官衰竭评估（SOFA）评分>12（OR=0.45；95％CI=0.23-0.88；P=0.020）和大剂量血管加压药治疗（OR=0.34；95％CI=0.14-0.79；P=0.012）。
结论：RFS影响了四分之一的危重患者，但对30天死亡率没有显著影响。恶性肿瘤,感染性休克,高NICERFS风险分级与RFS呈正相关，而高SOFA评分和广泛使用血管加压药与风险降低相关.
