RESUMO
OBJECTIVES: Refeeding syndrome is a life-threatening, physiological process that occurs when patients with severe malnutrition are too rapidly rehabilitated, leading to the development of electrolyte abnormalities. Hypophosphatemia, a hallmark of the disease, has most commonly been studied, because it is recognized to result in cardiac arrhythmias, seizures, cardiac failure, respiratory failure, rhabdomyolysis, coma, and even death. Although many studies have found caloric intake to be a main causal factor in refeeding syndrome, few have explored other factors, such as geographic location. Border cities, such as El Paso, Texas, have a unique, diverse population. The purpose of this study was to establish the incidence of refeeding syndrome concentrated within a border city. METHODS: We performed a retrospective chart review that focused on the incidence of refeeding syndrome in pediatric patients with eating disorders, ages 10 to 19 years, admitted to El Paso Children's Hospital, the only tertiary teaching hospital in the area, associated with Texas Tech University Health Science Center, located along the US-Mexico border, in El Paso, Texas. RESULTS: Twenty-six subjects with a diagnosis of eating disorder were admitted to El Paso Children's Hospital for treatment between 2012 and 2019. Five subjects developed refeeding syndrome, recognized in our study as hypokalemia or hypomagnesemia, during their treatment. CONCLUSIONS: Among hospitalized adolescents admitted to El Paso Children's Hospital, 19% developed refeeding syndrome. This incidence was higher in our population than had been previously reported. Further research is needed to better establish a protocol for the treatment of patients with eating disorders.
Assuntos
Pediatria/estatística & dados numéricos , Síndrome da Realimentação/diagnóstico , Adolescente , Criança , Emigração e Imigração/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Masculino , México/epidemiologia , Pediatria/métodos , Síndrome da Realimentação/epidemiologia , Estudos Retrospectivos , Texas/epidemiologiaRESUMO
BACKGROUND: Refeeding syndrome (RS) is characterized by severe electrolyte derangement that may be associated with worse clinical outcomes in hospitalized patients. In this study, we aim to assess the incidence of RS in inpatients receiving parenteral nutrition (PN) and its possible association with the length of hospital stay (LHS) and mortality. METHODS: We conducted a historical cohort study involving adults receiving PN, monitored by a nutrition therapy team in a Brazilian public hospital. Data collection was made from electronic records. We assessed the presence of RS after PN therapy was initiated. The amount of energy delivered within 72 hours of PN, LHS, and mortality were compared between patients with and without RS. RESULTS: One-hundred ninety-seven patients (aged 57.7 ± 14.1 years; 55.7% men) were followed for a median of 51 days. The incidence of RS was equal to 25.4%. The adequacy of energy delivered in relation to energy requirements within 72 hours (69.4% ± 29.3% vs 61.8% ± 21.6%) was higher in patients with RS than in those without RS (P = .054). The incidence of death was 55.3% and did not differ between groups. The median of LHS was equal to 51.0 (32.0-83.0) days, and it also did not differ between patients with and without RS. CONCLUSION: RS was identified in 25% of patients receiving PN, but it was not associated to mortality and LHS, even when energy delivery was considered in combination to RS.