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Effects of Early Enteral Nutrition on Patients After Emergency Gastrointestinal Surgery: A Propensity Score Matching Analysis

Early postoperative enteral feeding has been demonstrated to improve the outcome of patients who underwent surgery for gastrointestinal (GI) malignancies, trauma, perforation, and/or obstruction. Thus, this study was conducted to assess the efficacy of early postoperative enteral nutrition (EN) afte...

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Autores principales: Lee, Seung Hwan, Jang, Ji Young, Kim, Hyung Won, Jung, Myung Jae, Lee, Jae Gil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603119/
https://www.ncbi.nlm.nih.gov/pubmed/25526487
http://dx.doi.org/10.1097/MD.0000000000000323
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author Lee, Seung Hwan
Jang, Ji Young
Kim, Hyung Won
Jung, Myung Jae
Lee, Jae Gil
author_facet Lee, Seung Hwan
Jang, Ji Young
Kim, Hyung Won
Jung, Myung Jae
Lee, Jae Gil
author_sort Lee, Seung Hwan
collection PubMed
description Early postoperative enteral feeding has been demonstrated to improve the outcome of patients who underwent surgery for gastrointestinal (GI) malignancies, trauma, perforation, and/or obstruction. Thus, this study was conducted to assess the efficacy of early postoperative enteral nutrition (EN) after emergency surgery in patients with GI perforation or strangulation. The medical records of 484 patients, admitted between January 2007 and December 2012, were reviewed retrospectively. Patients were divided into 2 groups: the early EN (EEN, N = 77) group and the late EN (LEN, N = 407) group. The morbidity, mortality, length of hospital, and intensive care unit (ICU) stays were compared between the 2 groups. Propensity score matching was performed in order to adjust for any baseline differences. Patients receiving EEN had reduced in-hospital mortality rates (EEN 4.5% vs LEN 19.4%; P = 0.008), pulmonary complications (EEN 4.5% vs LEN 19.4%; P = 0.008), lengths of hospital stay (median: 14.0, interquartile range: 8.0–24.0 vs median: 17.0, interquartile range: 11.0–26.0, P = 0.048), and more 28-day ICU-free days (median: 27.0, interquartile range: 25.0–27.0 vs median: 25.0, interquartile range: 22.0–27.0, P = 0.042) than those receiving LEN in an analysis using propensity score matching. The significant difference in survival between the 2 groups was also shown in the Kaplan–Meier survival curve (P = 0.042). In a further analysis using the Cox proportional hazard ratio after matching on the propensity score, EEN was associated with reduced in-hospital mortality (hazard ratio, 0.03; 95% confidence interval, 0.01–0.49; P = 0.015). EEN is associated with beneficial effects, such as reduced in-hospital mortality rates, pulmonary complications, lengths of hospital stay, and more 28-day ICU-free days, after emergency GI surgery.
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spelling pubmed-46031192015-10-27 Effects of Early Enteral Nutrition on Patients After Emergency Gastrointestinal Surgery: A Propensity Score Matching Analysis Lee, Seung Hwan Jang, Ji Young Kim, Hyung Won Jung, Myung Jae Lee, Jae Gil Medicine (Baltimore) 7100 Early postoperative enteral feeding has been demonstrated to improve the outcome of patients who underwent surgery for gastrointestinal (GI) malignancies, trauma, perforation, and/or obstruction. Thus, this study was conducted to assess the efficacy of early postoperative enteral nutrition (EN) after emergency surgery in patients with GI perforation or strangulation. The medical records of 484 patients, admitted between January 2007 and December 2012, were reviewed retrospectively. Patients were divided into 2 groups: the early EN (EEN, N = 77) group and the late EN (LEN, N = 407) group. The morbidity, mortality, length of hospital, and intensive care unit (ICU) stays were compared between the 2 groups. Propensity score matching was performed in order to adjust for any baseline differences. Patients receiving EEN had reduced in-hospital mortality rates (EEN 4.5% vs LEN 19.4%; P = 0.008), pulmonary complications (EEN 4.5% vs LEN 19.4%; P = 0.008), lengths of hospital stay (median: 14.0, interquartile range: 8.0–24.0 vs median: 17.0, interquartile range: 11.0–26.0, P = 0.048), and more 28-day ICU-free days (median: 27.0, interquartile range: 25.0–27.0 vs median: 25.0, interquartile range: 22.0–27.0, P = 0.042) than those receiving LEN in an analysis using propensity score matching. The significant difference in survival between the 2 groups was also shown in the Kaplan–Meier survival curve (P = 0.042). In a further analysis using the Cox proportional hazard ratio after matching on the propensity score, EEN was associated with reduced in-hospital mortality (hazard ratio, 0.03; 95% confidence interval, 0.01–0.49; P = 0.015). EEN is associated with beneficial effects, such as reduced in-hospital mortality rates, pulmonary complications, lengths of hospital stay, and more 28-day ICU-free days, after emergency GI surgery. Wolters Kluwer Health 2014-12-02 /pmc/articles/PMC4603119/ /pubmed/25526487 http://dx.doi.org/10.1097/MD.0000000000000323 Text en © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0
spellingShingle 7100
Lee, Seung Hwan
Jang, Ji Young
Kim, Hyung Won
Jung, Myung Jae
Lee, Jae Gil
Effects of Early Enteral Nutrition on Patients After Emergency Gastrointestinal Surgery: A Propensity Score Matching Analysis
title Effects of Early Enteral Nutrition on Patients After Emergency Gastrointestinal Surgery: A Propensity Score Matching Analysis
title_full Effects of Early Enteral Nutrition on Patients After Emergency Gastrointestinal Surgery: A Propensity Score Matching Analysis
title_fullStr Effects of Early Enteral Nutrition on Patients After Emergency Gastrointestinal Surgery: A Propensity Score Matching Analysis
title_full_unstemmed Effects of Early Enteral Nutrition on Patients After Emergency Gastrointestinal Surgery: A Propensity Score Matching Analysis
title_short Effects of Early Enteral Nutrition on Patients After Emergency Gastrointestinal Surgery: A Propensity Score Matching Analysis
title_sort effects of early enteral nutrition on patients after emergency gastrointestinal surgery: a propensity score matching analysis
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603119/
https://www.ncbi.nlm.nih.gov/pubmed/25526487
http://dx.doi.org/10.1097/MD.0000000000000323
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