Incidence and risk factors of refeeding syndrome in inpatients undergoing enteral and parenteral nutrition hospitalized in a university medical hospital.

Refeeding syndrome (RS) encompasses electrolyte and metabolic disturbances, and its incidence depends on diagnostic criteria. We aimed to evaluate the incidence and risk factors for RS in inpatients at a university hospital in Brazil, who received enteral or parenteral nutrition. This retrospective study included all patients admitted to the hospital who received enteral or parenteral feeding after at least a 3-day fasting period. RS diagnosis was based on phosphorus, potassium, and magnesium changes in the first 3 days after diet reintroduction. Clinical, anthropometric, and other laboratory evaluations, as well as caloric prescriptions, were also collected. Risk factors for RS development were evaluated using logistic regression, and the 30-day mortality risk associated with RS was analyzed using Cox regression. A total of 315 participants were included in the final analysis. The median age was 65 years, 55% were men, 45% had a diagnosis of cancer, and the body mass index was 23.7 (IQR: 20.5-27.0) kg/m2. Development of RS was found in 36.8%. The risks associated with RS development were female gender and higher serum phosphorus and sodium levels. The 30-day survival rates for patients with or without RS were 50.7 and 49.9%, respectively (P=0.42). In the Cox regression model, the diagnosis of RS was not associated with death risk (HR: 0.81, 95%CI: 0.54-1.21). In conclusion, a high incidence of RS was found, but this was not associated with increased death risk, which could be explained by the prompt diagnosis and correction of electrolyte deficits.