Delay in post-endoscopic refeeding in patients with upper GI bleeding leads to increased hospital length of stay.

Autor:	Sutton MM; Department of Internal Medicine, Medical University of South Carolina, Charleston, S.C. USA., Gregoski MJ; Department of Public Health Sciences, Medical University of South Carolina, Charleston, S.C. USA., Rockey DC; Digestive Disease Research Center, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 908, Charleston, S.C. 29425, USA. Electronic address: rockey@musc.edu.
Jazyk:	angličtina
Zdroj:	The American journal of the medical sciences [Am J Med Sci] 2024 Sep; Vol. 368 (3), pp. 190-195. Date of Electronic Publication: 2024 Jan 20.
DOI:	10.1016/j.amjms.2024.01.010
Abstrakt:	Background: Patients with acute upper gastrointestinal bleeding (UGIB) are made NPO prior to endoscopy. It is standard practice in those found to have low risk lesions to immediately resume a usual diet. Here, we evaluated refeeding practices in hospitalized patients with UGIB after endoscopy. Methods: In this retrospective single-center cross-sectional study, we examined patients over the age of 18 with acute UGIB and low risk or no endoscopic lesion(s). Appropriate refeeding was categorically defined as resuming normal diet ≤ 4 h post-endoscopy. Results: Of 230 patients (mean age, 62 years; 57% female) with acute UGIB and low-risk lesions or no lesion(s), 96 [41% (95% CI: 35% to 48%)] received their usual diet within 4 h after EGD. For the remaining 134 patients, refeeding was delayed on average from 13 (NPO until regular diet) to 31 (NPO until liquid diet, then regular diet) hours. Baseline clinical features were identical in patients who received their regular diet within 4 h after EGD and those who did not. Hospital length of stay was shorter in patients receiving usual diets promptly (5.3 days vs. 6.4 days, p = 0.03). Patients in an ICU at the time of their endoscopy had a statistically significantly higher probability of not being refed appropriately [OR 2.371, 95% CI 1.191-4.722). Conclusions: Inappropriate dietary restrictions are frequent in patients with UGIB caused by low risk lesions. This delay in refeeding leads to increased length of hospital stay - suggesting that appropriate refeeding is an opportunity to improve patient care. Competing Interests: Declaration of competing interest The authors certify that we have no financial arrangements (e.g., consultancies, stock ownership, equity interests, patent-licensing arrangements, research support, honoraria, etc.) with a company whose product figures prominently in this manuscript or with a company making a competing product. (Copyright © 2024 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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