Late Nutrition and Negative Outcomes in a Brazilian Paediatric Intensive Care Unit: A Retrospective Cohort.

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health Pub Date : 2025-04-05 DOI:10.1111/jpc.70049

Arnildo Linck Júnior, Flávia Lopes Gabani, Edmarlon Girotto, Ana Maria Rigo Silva, Selma Maffei de Andrade

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引用次数: 0

Abstract

Aim: To analyse the association between late initiation of enteral nutrition and negative outcomes in the Paediatric Intensive Care Unit (PICU) in Brazil.

Method: This was a retrospective cohort study with data from the medical records of children hospitalised between 2012 and 2017. The independent variable was late initiation of enteral nutrition (> 24 h after admission). The outcomes analysed included longer length of stay in the PICU and hospital, incidence of healthcare-related infections (HAIs), and death. Poisson regression models with robust variance were adjusted for potentially confounding variables by presenting relative risks (RR) and 95% confidence intervals (95% CI).

Results: We analysed 840 hospitalizations: 311 (37.0%) with delayed initiation of nutrition, 252 (30.0%) with a diagnosis of HAIs, and 93 deaths (11.1%). After all adjustments, late initiation of enteral nutrition was associated with longer lengths of stay in the PICU (RR: 1.41; 95% CI: 1.01-1.30), hospital stay (RR: 1.22; 95% CI: 1.06-1.41), and higher HAI incidence (RR: 1.40; 95% CI: 1.14-1.73). The association with mortality was no longer significant after adjusting for the admission severity indicators.

Conclusion: The results indicate that late initiation of nutrition can lead to longer PICU and hospital stays and a higher incidence of HAIs.

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巴西儿科重症监护病房的晚期营养和负面结果：回顾性队列。

目的：分析巴西儿科重症监护病房（PICU）晚开始肠内营养与不良结局之间的关系。方法：这是一项回顾性队列研究，数据来自2012年至2017年住院儿童的医疗记录。自变量为肠内营养起始时间较晚（入院后24 h）。分析的结果包括在PICU和医院的住院时间更长，医疗保健相关感染（HAIs）的发生率和死亡。通过呈现相对风险（RR）和95%置信区间（95% CI），对具有稳健方差的泊松回归模型进行校正，以排除潜在的混杂变量。结果：我们分析了840例住院病例：311例（37.0%）延迟开始营养，252例（30.0%）诊断为HAIs， 93例死亡（11.1%）。经过所有调整后，肠内营养开始较晚与PICU住院时间较长相关(RR: 1.41；95% CI: 1.01-1.30)、住院时间(RR: 1.22；95% CI: 1.06-1.41)和较高的HAI发生率(RR: 1.40；95% ci: 1.14-1.73)。在调整入院严重程度指标后，与死亡率的关联不再显著。结论：较晚开始营养治疗可延长重症监护病房和住院时间，增加HAIs发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of paediatrics and child health 医学-小儿科

CiteScore

2.90

自引率

5.90%

发文量

487

审稿时长

3-6 weeks

期刊介绍： The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.