ArticlePerioperative medicine (London, England)2024
Validity of the I‑FEED classification in assessing postoperative gastrointestinal impairment in patients undergoing elective lumbar spinal surgery with general anesthesia: a prospective observational study.
Article in Perioperative medicine (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Effects of remote ischemic preconditioning on postoperative gastrointestinal function in patients undergoing off-pump coronary artery bypass grafting: a randomized controlled trial.BMC anesthesiology · 2026Trial
- A novel dexmedetomidine nasal spray for gastrointestinal recovery in pediatric laparoscopic hernia repair: a randomized controlled trial.BMC anesthesiology · 2026Trial
- Dexmedetomidine-Ketamine-Based Multimodal General Anesthesia with Electroencephalographic Spectrogram-Guided Titration Improves Early Recovery After Lumbar Spine Fusion in Older Adults: A Randomized Controlled Trial.Drug design, development and therapy · 2026Trial
- Enteral nutrition intolerance: Evidence mapping of definitions and assessment practices to inform future gastric cancer-specific assessment tool development.Asia Pacific journal of clinical nutrition · 2026Review
- Gastrointestinal dysfunction associated with autoimmune glial fibrillary acidic protein astrocytopathy.Journal of neurology · 2026Article
- Risk factors for postoperative gastrointestinal dysfunction in adult patients undergoing short laparoscopic surgery: a prospective exploratory observational study.BMC anesthesiology · 2026Observational
- Machine learning-based risk prediction model for postoperative abdominal distension after spinal surgery under general anesthesia.Frontiers in medicine · 2026Article
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7 authors.
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Abstract
backgroundThe I-FEED classification, scored 0-8, was reported to accurately describe the clinical manifestations of gastrointestinal impairment after colorectal surgery. Therefore, it is interesting to determine whether the I-FEED scoring system is also applicable to patients undergoing lumbar spine surgery.
methodsAdult patients undergoing elective lumbar spine surgery were enrolled, and the I-FEED score was measured for 4 days after surgery. The I-FEED scoring system incorporates five elements: intake (score: 0, 1, 3), feeling nauseated (score: 0, 1, 3), emesis (score: 0, 1, 3), results of physical exam (score: 0, 1, 3), and duration of symptoms (score: 0, 1, 2). Daily I-FEED scores were summed, and the highest overall score is used to categorize patients into one of three categories: normal (0-2 points), postoperative gastrointestinal intolerance (POGI; 3-5 points), and postoperative gastrointestinal dysfunction (POGD; 6 + points). The construct validity hypothesis testing determines whether the I-FEED category is consistent with objective clinical findings relevant to gastrointestinal impairment, namely, the longer length of hospital stay (LOS), higher inhospital medical cost, more postoperative gastrointestinal medical treatment, and more postoperative non-gastrointestinal complications.
resultsA total of 156 patients were enrolled, and 25.0% of patients were categorized as normal, 49.4% POGI, and 25.6% POGD. Patients with higher I-FEED scores agreed with the four validity hypotheses. Patients with POGD had a significantly longer length of hospital stay (1 day longer median stay; p = 0.049) and more inhospital medical costs (approximately 500 Taiwanese dollars; p = 0.037), and more patients with POGD required rectal laxatives (10.3% vs. 32.5% vs. 32.5%; p = 0.026). In addition, more patients with POGD had non-gastrointestinal complications (5.1% vs. 11.7% vs. 30.0%; p = 0.034).
conclusionThis study contributes preliminary validity evidence for the I-FEED score as a measure for postoperative gastrointestinal impairment after elective lumbar spine surgery.
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