JPEN. Journal of parenteral and enteral nutrition最新文献

{"title":"Early dietitian-led nutrition intervention and unplanned intensive care unit transfer in hospitalized adults with nutritional risk: A retrospective cohort study.","authors":"Yana Qi, Xuemei Li, Lei Shi, Wen Hu, Ningsu Chen, Dongyu Mu, Yuan Liu, Fengmei Yu, Xiaofan Jing, Yi Cheng, Tingting Dai, Zhiyong Rao, Jiajie Yu","doi":"10.1002/jpen.70157","DOIUrl":"https://doi.org/10.1002/jpen.70157","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition and nutritional risk are common among inpatients and are associated with adverse outcomes. Although dietitian-led individualized nutrition intervention is recommended, evidence from routine practice among non-critically ill inpatients remains limited. We aimed to evaluate the association between early dietitian-led nutrition intervention and deterioration-related outcomes among adults at nutritional risk.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using electronic medical records from a Chinese tertiary hospital (2016-2023). Adults aged 18-90 years with Nutritional Risk Screening 2002 scores ≥3 were included; patients directly admitted to intensive care unit were excluded. Patients receiving early dietitian-led nutrition intervention within 72 h after hospital admission were propensity score matched 1:1 to comparators. Outcomes were unplanned intensive care unit transfer, major gastrointestinal events after admission, and predefined clinically meaningful changes in laboratory indicators. Associations were estimated using logistic regression and reported as odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 96,532 eligible patients, 16,661 (17.3%) received early dietitian-led nutrition intervention. After matching, 16,419 pairs were analyzed. Early dietitian-led nutrition intervention was associated with lower odds of intensive care unit transfer (3.0% vs. 3.4%; OR 0.88, 95% CI 0.77-0.99), major gastrointestinal events (4.0% vs. 4.4%; OR 0.89, 95% CI 0.80-0.99), and higher odds of clinically meaningful reduction in C-reactive protein (12.6% vs. 10.9%; OR 1.18, 95% CI 1.11-1.27).</p><p><strong>Conclusion: </strong>Early dietitian-led nutrition intervention was associated with lower odds of deterioration-related outcomes among hospitalized adults at nutritional risk. Limited early dietitian involvement despite routine nutritional risk screening suggests an implementation gap and warrants further prospective evaluation.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catheter-related bloodstream infections, infective endocarditis, and vertebral osteomyelitis in adults receiving home parenteral nutrition: A descriptive cohort study.","authors":"Selma Maria Boltz-Jensen, Jakob Møller Vandbæk, Abina Mohanaraj, Sofie Kibsgaard Dall, Charlotte Lock Rud, Janne Fassov, Henrik Højgaard Rasmussen, Jakob Lykke Poulsen, Christian Lodberg Hvas, Lars Vinter-Jensen","doi":"10.1002/jpen.70152","DOIUrl":"https://doi.org/10.1002/jpen.70152","url":null,"abstract":"<p><strong>Background: </strong>Intestinal failure patients receiving home parenteral nutrition are at risk of catheter-related bloodstream infection. Metastatic infections include infective endocarditis and vertebral osteomyelitis. We aimed to investigate the incidences of catheter-related bloodstream infection, infective endocarditis, and vertebral osteomyelitis in type 3 intestinal failure patients.</p><p><strong>Methods: </strong>This was a cohort study conducted in a Danish referral intestinal failure center. All data on catheter-related bloodstream infections, infective endocarditis, and vertebral osteomyelitis were retrieved from medical records on patients receiving home parenteral nutrition through tunneled cuffed central venous access devices or peripherally inserted central catheters from 01 January 2019 to 31 December 2023.</p><p><strong>Results: </strong>A total of 323 patients (209 females) were included, totaling 913 catheters and 293,650 catheter days. The catheter-related bloodstream infection incidence was 0.93 per 1,000 catheter days (95% CI: 0.82-1.03) over the 5-year period, with a statistically significantly higher incidence for tunneled cuffed central venous access devices than for peripherally inserted central catheters (1.10 [95% CI: 0.95-1.26] vs. 0.66 [95% CI: 0.52-0.81] per 1,000 catheter days, respectively). Thirteen cases of infective endocarditis (0.04 per 1,000 catheter days [95% CI: 0.02-0.07]) and ten cases of vertebral osteomyelitis (0.03 per 1000 [95% CI: 0.01-0.06]) were identified.</p><p><strong>Conclusion: </strong>The catheter-related bloodstream infection incidence is within the acceptable range recommended by current guidelines. The incidence of infective endocarditis is higher, and that of vertebral osteomyelitis is similar to those in other studies. Catheter-related bloodstream infection is a serious complication that may lead to infective endocarditis or vertebral osteomyelitis, underscoring the need for timely detection and management.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition defined by three global leadership initiative on malnutrition-based models and the risk of all-cause mortality in adults with common cancers: A retrospective cohort study.","authors":"Shuyao Wang, Changhong Xu, Nuo Xu, Siyu Lin, Yibo Chen, Changyang Chen, Junfei Chen, Yuhang Zhang, Hailun Xie","doi":"10.1002/jpen.70153","DOIUrl":"https://doi.org/10.1002/jpen.70153","url":null,"abstract":"<p><strong>Objective: </strong>Our study compared the diagnostic agreement and prognostic value for overall survival of three nutritional screening tools integrated with the Global Leadership Initiative on Malnutrition framework in patients with cancer.</p><p><strong>Methods: </strong>The nutritional screening tools evaluated were the Malnutrition Universal Screening Tool, Malnutrition Screening Tool, and Nutritional Risk Screening 2002. Prognostic assessment was conducted using Kaplan-Meier survival analysis and Cox proportional hazards regression, with sensitivity analyses to ensure robustness. Logistic regression analysis was employed to assess the predictive value of each Global Leadership Initiative on Malnutrition-based model for malnutrition. Harrell's concordance index compared the discriminatory power of the models for overall survival outcomes, while kappa statistics evaluated diagnostic consistency for malnutrition across the models.</p><p><strong>Results: </strong>Each of the three models combining the Global Leadership Initiative on Malnutrition criteria with the Malnutrition Universal Screening Tool, the Malnutrition Screening Tool, or Nutritional Risk Screening 2002 was independently associated with an increased risk of all-cause mortality. The corresponding hazard ratios were 1.494, 1.517, and 1.530, respectively, with all P values less than 0.001. Across all three models, mortality risk increased progressively with the severity of malnutrition, while their discriminatory performance for overall survival was comparable. Among the three models, the model incorporating the Malnutrition Screening Tool demonstrated the strongest agreement with the Patient-Generated Subjective Global Assessment (kappa = 0.481, P < 0.001) and the greatest ability to identify malnutrition.</p><p><strong>Conclusions: </strong>All three models provided meaningful prognostic information. The model incorporating the Malnutrition Screening Tool showed the closest diagnostic agreement and the strongest identification of clinically significant malnutrition.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total parenteral nutrition exposure in neonates and the risk of long-term food allergy: A retrospective cohort study.","authors":"Tak Kyu Oh, In-Ae Song","doi":"10.1002/jpen.70154","DOIUrl":"https://doi.org/10.1002/jpen.70154","url":null,"abstract":"<p><strong>Background: </strong>Total parenteral nutrition (TPN) is essential for critically ill neonates but bypasses enteral stimulation and may induce gut dysbiosis, raising concern about long-term allergic outcomes. We hypothesized that neonatal TPN exposure is associated with an increased risk of food allergy in infants compared with the absence of TPN.</p><p><strong>Methods: </strong>Using the South Korean National Health Insurance Service database, we followed 2,325,275 infants born between 2005 and 2010 from their first birthday until December 31, 2023. Our exposure of interest was TPN administered during the first 28 days of life; our primary outcome was the initial clinical diagnosis of food allergy after the first year of life. Propensity score overlap weighting, targeting the average treatment effect in the overlap population, constituted the primary analysis, with robust sandwich variance estimators.</p><p><strong>Results: </strong>In total, 7661 infants (0.33%) received TPN. Food allergy occurred in 156 TPN-exposed infants (1.33 per 1000 person-years) and 45,608 unexposed infants (1.23 per 1000 person-years). The unadjusted association (hazard ratio [HR], 1.42; 95% CI: 1.21-1.66) was fully attenuated after overlap weighting (HR, 1.00; 95% CI: 0.83-1.21; P = 0.99). Results were consistent in multivariable, pre-exposure-covariate-only, and competing-risks (Fine-Gray) analyses, across food allergy subtypes and high-risk subgroups, and no association was observed per additional day of TPN administration.</p><p><strong>Conclusion: </strong>Neonatal TPN exposure was not significantly associated with the long-term risk of food allergy. The unadjusted association appears attributable to confounding by baseline clinical severity, although a modest increase in risk cannot be excluded.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of bioelectrical impedance analysis in patients with cardiac implantable electronic devices: A systematic review.","authors":"H Zweers, Z Zhao, E Noom, W Visser, I Jans, L Willems, M Verhoeven, D A Theuns, H Jager-Wittenaar","doi":"10.1002/jpen.70150","DOIUrl":"https://doi.org/10.1002/jpen.70150","url":null,"abstract":"<p><strong>Background: </strong>Bioelectrical impedance analysis is widely used in clinical settings to assess body composition, contributes to the management of various health conditions. However, for patients with cardiac implantable electronic devices, such as pacemakers and implantable cardioverter-defibrillators, concerns about electromagnetic interference have led to longstanding recommendations against using bioelectrical impedance analysis. In this systematic review, we aimed to assess the available evidence regarding the safety of cardiac implantable electronic devices (CIEDs) during bioelectrical impedance analysis procedures.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched PubMed, IEEE Xplore, Embase, and CINAHL for studies reporting on bioelectrical impedance analysis safety in patients with cardiac implantable electronic devices. Inclusion criteria focused on human studies reporting CIED function outcomes during BIA measurements. Data on BIA frequencies, types of CIEDs and BIA, and observed electromagnetic interference effects were extracted. The quality and bias of the studies were assessed using the Oxford Levels of Evidence and ROBINS-I tools.</p><p><strong>Results: </strong>Out of 2003 records screened, 8 studies were included, encompassing 866 BIA measurements across frequencies ranging from 5 to 500 kHz. No studies reported electromagnetic interference or adverse events affecting CIED functionality.</p><p><strong>Conclusion: </strong>No evidence of electromagnetic interference or adverse effects on CIED function was identified in the available studies evaluating BIA in patients with CIEDs. These findings support reconsideration of clinical recommendations that discourage BIA use in this population.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urea-to-Creatinine-Ratio and the risk of 28-day mortality in critically ill adults with or without Acute Kidney Injury: A post-hoc analysis of a randomized clinical trial.","authors":"Lingliang Zhou, Cheng Lv, Xiangcheng Zhang, Yang Liu, Yufeng Zhou, Arthur Raymond Hubert van Zanten, Wenjian Mao, Lu Ke, Weiqin Li","doi":"10.1002/jpen.70148","DOIUrl":"https://doi.org/10.1002/jpen.70148","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of the urea-to-creatinine ratio in critically ill adults may vary according to the timing of measurement and baseline acute kidney injury status. We hypothesized that higher urea-to-creatinine ratios measured on study Days 1 and 7 would be associated with higher 28-day mortality, and that these associations would differ according to baseline acute kidney injury status.</p><p><strong>Methods: </strong>We performed a post hoc analysis of the multicenter cluster-randomized trial. The urea-to-creatinine ratio was measured on study Days 1 and 7 (mmol/mmol). Restricted cubic spline-adjusted Cox models assessed associations between the urea-to-creatinine ratio and time to death through Day 28 in the overall population and according to baseline acute kidney injury status. Multivariable linear regression identified factors associated with Day 7 urea-to-creatinine ratio.</p><p><strong>Results: </strong>The Day 1 and Day 7 analyses included 2613 and 2516 patients, respectively. The urea-to-creatinine ratio was higher on Day 7 than on Day 1 and lower in patients with baseline acute kidney injury than in those without baseline acute kidney injury. No clear association was observed between the Day 1 urea-to-creatinine ratio and 28-day mortality in the overall population or after stratification by baseline acute kidney injury status. The Day 7 urea-to-creatinine ratio was associated with 28-day mortality in the overall population and showed a U-shaped association in patients without baseline acute kidney injury, whereas no clear association was observed in patients with baseline acute kidney injury. In the Day 7 cohort without baseline acute kidney injury, low and high urea-to-creatinine ratio cohorts had higher mortality than the middle urea-to-creatinine ratio cohort, with adjusted hazard ratios of 2.06 (95% confidence interval, 1.30-3.26) and 2.21 (95% confidence interval, 1.45-3.38), respectively. Higher protein delivery and older age were associated with higher Day 7 urea-to-creatinine ratio, whereas baseline acute kidney injury, male sex, and higher body mass index were associated with lower Day 7 urea-to-creatinine ratio.</p><p><strong>Conclusion: </strong>No clear association between the Day 1 urea-to-creatinine ratio and 28-day mortality was observed in the overall population or after stratification by baseline acute kidney injury status. On Day 7, the urea-to-creatinine ratio was associated with 28-day mortality, with a U-shaped association in patients without baseline acute kidney injury but no clear association in patients with baseline acute kidney injury. The urea-to-creatinine ratio should be interpreted cautiously in patients with acute kidney injury.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JPEN Journal Club 104. Pragmatic trials.","authors":"Ronald L Koretz","doi":"10.1002/jpen.70151","DOIUrl":"https://doi.org/10.1002/jpen.70151","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between essential fatty acid source and Holman index in preterm infants: A prospective cohort study.","authors":"Megan Carney, Kimberly Campbell, Radhika Maddali, Mimi Kim, Qi Gao, John Thompson, Caterina Tiozzo","doi":"10.1002/jpen.70147","DOIUrl":"https://doi.org/10.1002/jpen.70147","url":null,"abstract":"<p><strong>Background: </strong>Preterm infants are at risk for altered essential fatty acid status due to limited nutrient stores, immature metabolism, and variable nutritional exposures. The impact of enteral and parenteral fat sources on fatty acid profiles in this population remains poorly understood. We hypothesized that preterm infants receiving donor breast milk would demonstrate altered fatty acid profiles, higher Holman indices, and a greater prevalence of essential fatty acid deficiency compared with infants receiving maternal breast milk, formula, or parenteral nutrition.</p><p><strong>Methods: </strong>We conducted a prospective cohort study comparing fatty acid profiles of 49 preterm infants born between 23 weeks 0 days and 36 weeks 6 days gestation who received maternal breast milk, donor breast milk, formula, or parenteral nutrition with a multi-lipid intravenous emulsion (soybean, medium-chain triglyceride, olive, and fish oils) from 2023 to 2024. Essential fatty acid deficiency was defined as a Holman index (triene:tetraene ratio of Mead acid to arachidonic acid) >0.2.</p><p><strong>Results: </strong>Infants receiving donor breast milk demonstrated a higher Holman Index compared with maternal breast milk and formula groups, although most values remained below the threshold for essential fatty acid deficiency. Biochemical essential fatty acid deficiency was identified in six infants: three received donor breast milk and three received a multi-lipid intravenous emulsion of 3 g/kg.</p><p><strong>Conclusion: </strong>Exposure to donor breast milk and multi-lipid intravenous emulsion of 3 g/kg were associated with altered essential fatty acid status. Further studies are needed to determine the clinical significance of subthreshold alterations in Holman index values in preterm infants.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between intravenous phosphate repletion and serum phosphate relative to enteral repletion in hospitalized adults: A retrospective cohort study.","authors":"Deanna Forella, Mahmoud Ammar, Michele Moura, Ryan Wallace, Raymond Hau, Albert Zichichi","doi":"10.1002/jpen.70149","DOIUrl":"https://doi.org/10.1002/jpen.70149","url":null,"abstract":"<p><strong>Background: </strong>Enteral phosphate repletion may reduce the need for fluid replacement, decrease costs, and minimize waste. Enteral repletion has been previously shown to be noninferior to intravenous (IV) repletion. The primary objective of this study was to evaluate the association between IV and enteral phosphate repletion and 24-h serum phosphate response in hospitalized patients with hypophosphatemia.</p><p><strong>Methods: </strong>This was a retrospective, multicenter, observational study. Patients were included if they received at least one dose of IV or enteral phosphate with a serum phosphate level of <2.5 mg/dL. The primary outcome was the change in 24-h serum phosphate level between IV and enteral repletion groups.</p><p><strong>Results: </strong>A total of 2567 patients met inclusion criteria and 124 were selected randomly for feasibility. Ninety-eight (79%) patients received IV repletion and 26 (21%) patients received enteral repletion. Sixty-eight (69.4%) patients receiving IV phosphate were eligible to receive enteral phosphate. Change in 24-h serum phosphate was similar between enteral and IV groups [0.7 (0.5) vs. 1.2 (1.4); P = 0.07]. No patients in either group developed severe hypophosphatemia (<1 mg/dL) during the study period.</p><p><strong>Conclusion: </strong>IV and enteral phosphate repletion resulted in similar changes in serum levels without the development of severe hypophosphatemia. Most patients who received IV phosphate repletion were eligible to receive enteral repletion. These findings support the feasibility of enteral phosphate repletion in appropriately selected patients with mild to moderate hypophosphatemia.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between probiotics and 28-day mortality in critically ill adults: A retrospective cohort study.","authors":"Hayabusa Takano, Naoki Kanda, Minoru Yoshida, Hiroyuki Ohbe, Kensuke Nakamura","doi":"10.1002/jpen.70146","DOIUrl":"https://doi.org/10.1002/jpen.70146","url":null,"abstract":"<p><strong>Background: </strong>The gut microbiota plays a crucial role in the human microenvironment, and critically ill patients often experience gut microbiota dysbiosis. Although probiotics have been reported to improve clinical outcomes, evidence regarding their effect on mortality remains inconsistent. Furthermore, no study has examined whether probiotic administration influences the development of persistent inflammation, immunosuppression, and catabolism syndrome (PICS).</p><p><strong>Methods: </strong>This retrospective cohort study analyzed adult patients admitted to intensive care units using a claims database. Patients who received any probiotics between Days 1 and 3 were defined as the probiotics group, and the others as the comparator group. A propensity score-matched analysis was conducted. The primary outcome was 28-day mortality, and the secondary outcomes were PICS on Days 28 and 14, and other clinical indicators.</p><p><strong>Results: </strong>A total of 79,243 patients were included in the analysis, and 3730 matched pairs were generated. After matching, 28-day mortality was lower in the probiotics group than in the no-probiotics group (6.3% vs. 7.9% in the first dataset; pooled risk difference [95% confidence interval], -1.6% [-3.0% to -0.3%]). PICS on Day 28 and Day 14 did not significantly differ between the groups.</p><p><strong>Conclusions: </strong>In the present study, the early administration of probiotics to intensive care unit patients was associated with a lower incidence of 28-day mortality, but not with PICS on Days 28 or 14. These findings suggest that probiotics for critical illness may provide more benefits than risks.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}