Observational studyAsia Pacific journal of clinical nutrition2025
Occurrence and predictors of refeeding syndrome in adult patients receiving parenteral nutrition at a Malaysian teaching hospital: A retrospective study.
Observational study in Asia Pacific journal of clinical nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
objectivesRefeeding syndrome (RS) is a potentially life-threatening condition character-ised by significant electrolyte and fluid imbalances, posing a considerable risk in patients undergoing parenteral nutrition (PN) therapy. This study aimed to determine the occurrence, risk factors, severity, and complications of RS in a teaching hospital in Malaysia. METHODS AND STUDY
designA retrospective observational study was conducted using universal sampling from October to December 2023. Data were collected for adult patients receiving PN for more than 48 hours between July 2022 and July 2023 at Hospital Canselor Tuanku Muhriz.
resultsAmong 90 patients included, 30 (33.3%) developed RS. Upon consideration of interaction terms due to collinerity of variables, a statistically significant correlation was observed between pre-existing electrolyte derangements and RS occurrence (p = 0.001). Phosphate levels showed the most significant decline post-PN initiation (43%), followed by potassium (19%) and magnesium (17%), primarily within the first 24 hours. No significant associations were found between BMI, fasting duration, unintentional weight loss, or medication history and RS. However, fasting for more than five days (AOR 2.8, 95% CI 0.4-17.7) and ≥10% unintentional weight loss (AOR 1.8, 95% CI 0.4-7.7) increased the likelihood of RS.
conclusionsRS is prevalent among adult PN patients, predominantly with mild severity. Pre-existing electrolyte abnormalities, especially in phosphate levels, were robust predictors. Larger studies are needed to better elucidate the associations between risk factors and RS in the local population.
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