Trial reportMedicine2020
Refeeding syndrome is associated with increased mortality in malnourished medical inpatients: Secondary analysis of a randomized trial.
Trial report in Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07674589 (Combined Assessment of Gastrointestinal Hormones and Metabolomic Profiling Following Mixed-Meal Tolerance Tests in Patients at High Risk of Refeeding Syndrome), which is not on this map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Combined Assessment of Gastrointestinal Hormones and Metabolomic Profiling Following Mixed-Meal Tolerance Tests in Patients at High Risk of Refeeding Syndrome: Study Protocol
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Incidence and mortality of refeeding syndrome in critically ill patients: a systematic review and meta-analysis.Scientific reports · 2026Pooled it
- The Australasian Society of Parenteral and Enteral Nutrition: Consensus statements on refeeding syndrome.Nutrition & dietetics : the journal of the Dietitians Association of Australia · 2025Guideline
- Combined Assessment of Gastrointestinal Hormones and Metabolomic Profiling Following Mixed-Meal Tolerance Tests in Patients at Increased Risk of Refeeding Syndrome: Study Protocol.Journal of personalized medicine · 2026Article
- Famine, plague, and slaughters: The fleeing famine hypothesis of anorexia nervosa reconsidered.Psychological review · 2026Article
- Feeding the injured brain: nutrients, dose, timing, and monitoring.Intensive care medicine · 2026Review
- The impact and predictive value of refeeding syndrome on the short-term prognosis of patients with severe stroke: a retrospective cohort study.Frontiers in nutrition · 2026Article
- Incidence and risk factors of refeeding syndrome in inpatients undergoing enteral and parenteral nutrition hospitalized in a university medical hospital.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas · 2026Observational
- Analysis of influencing factors and nursing strategies for enteral nutrition patients complicated with refeeding syndrome in ICU.BMC gastroenterology · 2025Article
- Observational
- Cardiohistological Findings in Refeeding Syndrome.Cureus · 2024Article
- Article
- Observational
- Refeeding Syndrome in Older Hospitalized Patients: Incidence, Management, and Outcomes.Nutrients · 2023Article
- Development, Design and Utilization of a CDSS for Refeeding Syndrome in Real Life Inpatient Care-A Feasibility Study.Nutrients · 2023Article
- Refeeding Syndrome.Deutsches Arzteblatt international · 2023Review
- Review
- Refeeding syndrome in a woman with pancreatitis: a case report.The Journal of international medical research · 2021Article
- Further evidence to throw caution to the wind: outcomes using an assertive approach to manage refeeding syndrome risk.European journal of clinical nutrition · 2021Article
- Hepatic ballooning degeneration: a new feature of the refeeding syndrome in rats.Clinical and experimental hepatology · 2020Article
- Management of Refeeding Syndrome in Medical Inpatients.Journal of clinical medicine · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhether the occurrence of refeeding syndrome (RFS), a metabolic condition characterized by electrolyte shifts after initiation of nutritional therapy, has a negative impact on clinical outcomes remains ill-defined. We prospectively investigated a subgroup of patients included in a multicentre, nutritional trial (EFFORT) for the occurrence of RFS.
methodsIn this secondary analysis of a randomized-controlled trial investigating the effects of nutritional support in malnourished medical inpatients, we prospectively screened patients for RFS and classified them as "RFS confirmed" and "RFS not confirmed" based on predefined criteria (i.e. electrolyte shifts, clinical symptoms, clinical context, and patient history). We assessed associations of RFS and mortality within 180 days (primary endpoint) and other secondary endpoints using multivariable regression analysis.
resultsAmong 967 included patients, RFS was confirmed in 141 (14.6%) patients. Compared to patients with no evidence for RFS, patients with confirmed RFS had significantly increased 180-days mortality rates (42/141 (29.8%) vs 181/826 (21.9%), adjusted odds ratio (OR) 1.53 (95% CI 1.02 to 2.29), P < .05). Patients with RFS also had an increased risk for ICU admission (6/141 (4.3%) vs 13/826 (1.6%), adjusted OR 2.71 (95% CI 1.01 to 7.27), P < .05) and longer mean length of hospital stays (10.5 ± 6.9 vs 9.0 ± 6.6 days, adjusted difference 1.57 days (95% CI 0.38-2.75), P = .01).
conclusionA relevant proportion of medical inpatients with malnutrition develop features of RFS upon hospital admission, which is associated with long-term mortality and other adverse clinical outcomes. Further studies are needed to develop preventive strategies for RFS in this patient population.
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