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©The Author(s) 2022.
World J Gastrointest Surg. Dec 27, 2022; 14(12): 1363-1374
Published online Dec 27, 2022. doi: 10.4240/wjgs.v14.i12.1363
Published online Dec 27, 2022. doi: 10.4240/wjgs.v14.i12.1363
Table 1 Baseline characteristics of the participants included in the analysis
| Variables | EFI group, n = 77 | Non-EFI group, n = 126 | Statistics | P value |
| Age in yr | 64.55 ± 15.86 | 69.06 ± 14.31 | t = 2.091 | 0.038 |
| Sex, n (%) | χ2 = 1.919 | 0.166 | ||
| Male | 55 (71.4) | 78 (61.9) | ||
| Female | 22 (28.6) | 48 (38.1) | ||
| BMI in kg/m2 | 23.64 ± 3.41 | 23.91 ± 4.70 | t = 0.030 | 0.672 |
| APACHE Ⅱ | 15.0 (9.0, 23.0) | 15.0 (9.5, 21.0) | Z = -0.117 | 0.907 |
| SOFA | 6.0 (3.0, 10.0) | 5.0 (1.0, 8.0) | Z = -1.533 | 0.125 |
| Diagnosis, n (%) | χ2 = 1.574 | 0.986 | ||
| Respiratory disease | 15 (19.5) | 26 (20.6) | ||
| Circulatory disease | 6 (7.8) | 9 (7.1) | ||
| Neurological disease | 12 (15.6) | 25 (19.8) | ||
| Digestive disease | 11 (14.3) | 18 (14.3) | ||
| Post-surgery | 22 (28.6) | 30 (23.8) | ||
| Sepsis | 5 (6.5) | 7 (5.6) | ||
| Multiple trauma | 3 (3.9) | 4 (3.2) | ||
| Other | 3 (3.9) | 7 (5.6) | ||
| Endpoint event, n (%) | ||||
| Diagnosis of EFI | 77 (100) | |||
| EN for more than 2 wk | 35 (27.8) | |||
| Transfer out of the ICU | 65 (51.6) | |||
| Gastric tube removal | 18 (14.3) | |||
| Death | 8 (6.3) |
Table 2 Enteral feeding intolerance occurrence in the case group, n (%)
| Variables | Case group, n = 77 |
| EN tube | |
| Nasogastric | 72 (93.5) |
| Nasal jejunal | 3 (3.9) |
| Jejunostomy | 2 (2.6) |
| When EFI occurred after EN started | |
| 1-3 d | 20 (26.0) |
| 4-7 d | 32 (41.6) |
| 8-14 d | 25 (32.5) |
| Number of days EFI lasted | |
| 1 d | 46 (59.7) |
| 2-3 d | 28 (36.4) |
| ≥ 4 d | 3 (3.9) |
| GI symptoms | |
| Diarrhea | 31 (40.3) |
| Abdominal distention | 22 (28.6) |
| Regurgitation | 14 (18.2) |
| Vomiting | 5 (6.5) |
| Aspiration | 2 (2.6) |
| Large GRV | 2 (2.6) |
| Constipation | 1 (1.3) |
Table 3 Univariate analysis of predictors associated with enteral feeding intolerance
| Variables | EFI group, n = 77 | Non-EFI group, n = 126 | Statistics | P value |
| Age in yr, mean ± SD | 64.55 ± 15.86 | 69.06 ± 14.31 | t = 2.091 | 0.038 |
| Sex, n (%) | χ2 = 1.919 | 0.166 | ||
| Male | 55 (71.4) | 78 (61.9) | ||
| Female | 22 (28.6) | 48 (38.1) | ||
| Diabetes, n (%) | 20 (26.0) | 33 (26.2) | χ2 = 0.001 | 0.973 |
| Abdominal surgery, n (%) | 9 (11.7) | 21 (16.7) | χ2 = 0.941 | 0.332 |
| GI disease, n (%) | 15 (19.5) | 37 (29.4) | χ2 = 2.451 | 0.117 |
| Head injury, n (%) | 14 (18.2) | 18 (14.3) | χ2 = 0.546 | 0.460 |
| Sepsis, n (%) | 5 (6.5) | 12 (9.5) | χ2 = 0.572 | 0.449 |
| Trauma, n (%) | 3 (3.9) | 8 (6.3) | 0.539 | |
| Analgesic, n (%) | 33 (42.9) | 49 (38.9) | χ2 = 0.313 | 0.576 |
| Sedative, n (%) | 49 (63.6) | 58 (46.0) | χ2 = 5.942 | 0.015 |
| Catecholamines, n (%) | 22 (28.6) | 26 (20.6) | χ2 = 1.667 | 0.197 |
| Early feeding, n (%) | 42 (54.5) | 88 (69.8) | χ2 = 4.856 | 0.028 |
| Feeding volume in mL | 1000 (500, 1500) | 1000 (500, 1400) | Z = -0.495 | 0.620 |
| Feeding speed in mL/h | 80 (50, 100) | 80 (50, 100) | Z = -0.220 | 0.826 |
| Mechanical ventilation, n (%) | ||||
| Before EN started | 54 (70.1) | 60 (47.6) | χ2 = 9.837 | 0.002 |
| When EN started | 54 (70.1) | 64 (50.8) | χ2 = 7.342 | 0.007 |
| Abnormal level of albumin, n (%) | ||||
| Diagnosis with hypoproteinemia | 1 (1.3) | 4 (3.2) | 0.652 | |
| Albumin before EN | 14 (18.2) | 21 (16.7) | χ2 = 0.077 | 0.782 |
| Albumin when EN started | 1 (1.3) | 6 (4.8) | 0.257 | |
| Abnormal level of electrolytes, n (%) | ||||
| Diagnosis with electrolyte disorders | 5 (6.5) | 12 (9.5) | χ2 = 0.572 | 0.449 |
| Before EN started, n (%) | ||||
| Potassium | 32 (41.6) | 45 (35.7) | χ2 = 0.693 | 0.405 |
| Sodium | 38 (49.4) | 49 (38.9) | χ2 = 2.136 | 0.144 |
| Chlorine | 54 (70.1) | 88 (69.8) | χ2 = 0.002 | 0.965 |
| Magnesium | 53 (68.8) | 81 (64.3) | χ2 = 0.440 | 0.507 |
| Calcium | 69 (89.6) | 118 (93.7) | χ2 = 1.075 | 0.300 |
| Phosphorus | 55 (71.4) | 77 (61.1) | χ2 = 2.237 | 0.135 |
| When EN started, n (%) | ||||
| Potassium | 14 (18.2) | 22 (17.5) | χ2 = 0.017 | 0.896 |
| Sodium | 32 (41.6) | 33 (26.2) | χ2 = 5.186 | 0.023 |
| Chlorine | 55 (71.4) | 76 (60.3) | χ2 = 2.578 | 0.108 |
| Magnesium | 38 (49.4) | 59 (46.8) | χ2 = 0.122 | 0.727 |
| Calcium | 69 (89.6) | 113 (89.7) | χ2 = 0.000 | 0.987 |
| Phosphorus | 43 (55.8) | 63 (50.0) | χ2 = 0.654 | 0.419 |
| Feeding formula, n (%) | χ2 = 10.861 | 0.048 | ||
| Rice soup | 10 (13.0) | 5 (4.0) | ||
| Peptisorb | 14 (18.2) | 39 (31.0) | ||
| Nutrison Fibre | 15 (19.5) | 33 (26.2) | ||
| TPF-D1 | 24 (31.2) | 32 (25.4) | ||
| TPF-T2 | 3 (3.9) | 2 (1.6) | ||
| Water | 11 (14.3) | 15 (11.9) |
Table 4 Final clinical prediction model of enteral feeding intolerance in the intensive care unit
| Variable | OR (95%CI) | Z statistic | P value |
| Age in yr | 0.98 (0.96, 1.00) | -1.881 | 0.060 |
| GI disease | 0.41 (0.18, 0.86) | -2.254 | 0.024 |
| Early feeding | 0.56 (0.28, 1.11) | -1.652 | 0.099 |
| MV before EN | 2.39 (1.27, 4.58) | 2.682 | 0.007 |
| Abnormal Na+ when EN started | 2.11 (1.11, 4.07) | 2.262 | 0.024 |
- Citation: Lu XM, Jia DS, Wang R, Yang Q, Jin SS, Chen L. Development of a prediction model for enteral feeding intolerance in intensive care unit patients: A prospective cohort study. World J Gastrointest Surg 2022; 14(12): 1363-1374
- URL: https://www.wjgnet.com/1948-9366/full/v14/i12/1363.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v14.i12.1363