Effects of early Enteral nutrition on patients after emergency gastrointestinal surgery

A propensity score matching analysis

Seung Hwan Lee, Ji Young Jang, Hyung Won Kim, Myung Jae Jung, JaeGil Lee

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Early postoperative enteral feeding has been demonstrated to improve the outcome of patients who underwent surgery for gastrointestinal (GI) malignancies, trauma, perforation, and/or obstruction. Thus, this study was conducted to assess the efficacy of early postoperative enteral nutrition (EN) after emergency surgery in patients with GI perforation or strangulation.The medical records of 484 patients, admitted between January 2007 and December 2012, were reviewed retrospectively. Patients were divided into 2 groups: the early EN (EEN, N = 77) group and the late EN (LEN, N = 407) group. The morbidity, mortality, length of hospital, and intensive care unit (ICU) stays were compared between the 2 groups. Propensity score matching was performed in order to adjust for any baseline differences.Patients receiving EEN had reduced in-hospital mortality rates (EEN 4.5% vs LEN 19.4%; P = 0.008), pulmonary complications (EEN 4.5% vs LEN 19.4%; P = 0.008), lengths of hospital stay (median: 14.0, interquartile range: 8.0-24.0 vs median: 17.0, interquartile range: 11.0-26.0, P = 0.048), and more 28-day ICU-free days (median: 27.0, interquartile range: 25.0-27.0 vs median: 25.0, interquartile range: 22.0-27.0, P = 0.042) than those receiving LEN in an analysis using propensity score matching. The significant difference in survival between the 2 groups was also shown in the Kaplan-Meier survival curve (P = 0.042). In a further analysis using the Cox proportional hazard ratio after matching on the propensity score, EEN was associated with reduced in-hospital mortality (hazard ratio, 0.03; 95% confidence interval, 0.01-0.49; P = 0.015).EEN is associated with beneficial effects, such as reduced in-hospital mortality rates, pulmonary complications, lengths of hospital stay, and more 28-day ICU-free days, after emergency GI surgery.

Original languageEnglish
Pages (from-to)e323
JournalMedicine (United States)
Volume93
Issue number28
DOIs
Publication statusPublished - 2014 Jan 1

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Propensity Score
Enteral Nutrition
Hospital Mortality
Emergencies
Length of Stay
Intensive Care Units
Lung
Mortality
Kaplan-Meier Estimate
Medical Records
Confidence Intervals
Morbidity
Survival
Wounds and Injuries
Neoplasms

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Lee, Seung Hwan ; Jang, Ji Young ; Kim, Hyung Won ; Jung, Myung Jae ; Lee, JaeGil. / Effects of early Enteral nutrition on patients after emergency gastrointestinal surgery : A propensity score matching analysis. In: Medicine (United States). 2014 ; Vol. 93, No. 28. pp. e323.
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title = "Effects of early Enteral nutrition on patients after emergency gastrointestinal surgery: A propensity score matching analysis",
abstract = "Early postoperative enteral feeding has been demonstrated to improve the outcome of patients who underwent surgery for gastrointestinal (GI) malignancies, trauma, perforation, and/or obstruction. Thus, this study was conducted to assess the efficacy of early postoperative enteral nutrition (EN) after emergency surgery in patients with GI perforation or strangulation.The medical records of 484 patients, admitted between January 2007 and December 2012, were reviewed retrospectively. Patients were divided into 2 groups: the early EN (EEN, N = 77) group and the late EN (LEN, N = 407) group. The morbidity, mortality, length of hospital, and intensive care unit (ICU) stays were compared between the 2 groups. Propensity score matching was performed in order to adjust for any baseline differences.Patients receiving EEN had reduced in-hospital mortality rates (EEN 4.5{\%} vs LEN 19.4{\%}; P = 0.008), pulmonary complications (EEN 4.5{\%} vs LEN 19.4{\%}; P = 0.008), lengths of hospital stay (median: 14.0, interquartile range: 8.0-24.0 vs median: 17.0, interquartile range: 11.0-26.0, P = 0.048), and more 28-day ICU-free days (median: 27.0, interquartile range: 25.0-27.0 vs median: 25.0, interquartile range: 22.0-27.0, P = 0.042) than those receiving LEN in an analysis using propensity score matching. The significant difference in survival between the 2 groups was also shown in the Kaplan-Meier survival curve (P = 0.042). In a further analysis using the Cox proportional hazard ratio after matching on the propensity score, EEN was associated with reduced in-hospital mortality (hazard ratio, 0.03; 95{\%} confidence interval, 0.01-0.49; P = 0.015).EEN is associated with beneficial effects, such as reduced in-hospital mortality rates, pulmonary complications, lengths of hospital stay, and more 28-day ICU-free days, after emergency GI surgery.",
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Effects of early Enteral nutrition on patients after emergency gastrointestinal surgery : A propensity score matching analysis. / Lee, Seung Hwan; Jang, Ji Young; Kim, Hyung Won; Jung, Myung Jae; Lee, JaeGil.

In: Medicine (United States), Vol. 93, No. 28, 01.01.2014, p. e323.

Research output: Contribution to journalArticle

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