Incidence and outcome of refeeding syndrome in neurocritically ill patients

Summary Background and aim Neurocritically ill patients are more likely to be comatose and suffer from dysphagia, conditions that inevitably require nutritional support. Inappropriate nutritional support may lead to refeeding syndrome (RFS). This study aimed to explore the incidence and outcome of RFS in neurocritically ill patients. Methods We conducted a retrospective study among neurocritically ill patients who received total enteral nutrition for > 72 hours in a university-affiliated hospital. RFS was defined as the occurrence of new-onset hypophosphatemia ( Results A total of 328 patients were enrolled, and 56 (17.1%) of them developed RFS within 72 hours of nutrition support. Significantly, we found that patients with high malnutrition universal screening tool (MUST) and sequential organ failure assessment (SOFA) scores were more likely to develop RFS. The occurrence of RFS was associated with a longer NCU stay, higher 30-day mortality and 6-month mortality, and poorer 6-month functional outcome. Moreover, RFS was identified as an independent risk factor for 6-month mortality. Conclusion RFS is not rare in neurocritically ill patients and is more likely to occur in patients with nutritional risk and more severe conditions. RFS is an independent risk factor for 6-month mortality in neurocritically ill patients.