Early Initiation of Feeding and In-Hospital Outcomes in Patients Hospitalized for Acute Heart Failure
Abstract
Extensive data on early nutrition support for patients requiring critical care are available. However, whether early initiation of feeding could be beneficial for patients hospitalized for acute heart failure (HF) remains unclear. We sought to compare outcomes of early and delayed initiation of feeding for hospitalized patients with acute HF using a nationwide inpatient database. We retrospectively analyzed data from the Diagnosis Procedure Combination database. We included patients hospitalized for HF between January 2010 and March 2018. We excluded patients with length of hospital stay ≤2 days, those patients who underwent major procedures under general anesthesia, and those requiring advanced mechanical supports within 2 days after admission including intubation, intra-aortic balloon pumping, and extracorporeal membrane oxygenation. Propensity score matching and instrumental variable analyses were conducted to compare in-hospital mortality, complications and length of stay between the early and delayed feeding groups. Among 432,620 eligible patients, 403,442 patients (93%) received early initiation of feeding (within 2 days after admission) and 29,178 patients (7%) received delayed initiation of feeding. Propensity score matching created 29,153 pairs and delayed initiation of feeding was associated with higher in-hospital mortality (odds ratio 1.32; 95% confidence interval 1.26 to 1.39), longer hospital stay and higher incidence of pneumonia and sepsis. The instrumental va…
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In a nationwide inpatient database of 432,620 patients hospitalized for acute heart failure after propensity score matching, delayed initiation of feeding later than two days after admission was associated with higher in-hospital mortality (OR 1.32, 95% CI 1.26 to 1.39), longer LOS and higher incidence of pneumonia and sepsis compared to earlier initiation.
“Using a nationwide inpatient database with 432,620 eligible patients hospitalized for acute heart failure after propensity score matching, Kaneko et al. showed that delayed initiation of feeding (later than two days after admission) was associated with higher in-hospital mortality (OR 1.32, 95% CI1.26 to 1.39), longer LOS and higher incidence of pneumonia and sepsis when compared to earlier init”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [109]
Cites
ESPEN guideline on clinical nutrition in the intensive care unit.
Singer, P., Blaser, A. R., Berger, M. M., Alhazzani, W., Calder, P. C., Casaer, M. P., Hiesmayr, M., Mayer, K., Montejo, J. C., Pichard, C., et al. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.08.037 · Cited by 2,904 · see citing works
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Cederholm, T., & Bosaeus, I. (2024) · New England Journal of Medicine · doi:10.1056/nejmra2212159 · Cited by 131 · see citing works
ESPEN guideline on nutritional support for polymorbid medical inpatients
Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works
“26 to 1.39), longer LOS and higher incidence of pneumonia and sepsis when compared to earlier initiation of feeding ( Level of evidence 2) [109].”
Influential
- Authors
- Kaneko, H., Itoh, H., Morita, K., Sugimoto, T., Konishi, M., Kamiya, K., Kiriyama, H., Kamon, T., Fujiu, K., Michihata, N., Jo, T., Takeda, N., Morita, H., Yasunaga, H., & Komuro, I.
- Affiliations
- The University of Tokyo (JP)
- University of Tsukuba (JP)
- Mie University Hospital (JP)
- Yokohama City University (JP)
- Kitasato University (JP)
- Corresponding author
- Kaneko, Hidehiro
- ORCID
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2021-04
- Volume
- 145
- Pages
- 85-90
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W3118247569
- Cited by
- 13
- References
- 1
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 1
- FWCI
- 1.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Boston Scientific Japan
- Medtronic Japan
- Ministry of Education, Culture, Sports, Science and Technology (20H03907)
- Ministry of Health, Labour and Welfare (19AA2007, 20AA2005)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- acute heart failure, enteral nutrition, in-hospital mortality, length of hospital stay, pneumonia, sepsis, hospitalized patients
- MeSH terms
- Acute Disease, Aged, Aged, 80 and over, Enteral Nutrition, Female, Heart Failure, Renal Dialysis, Hospitalization, Humans, Intra-Aortic Balloon Pumping, Intubation, Intratracheal, Japan, Length of Stay, Male, Pneumonia, Retrospective Studies, Time Factors, Extracorporeal Membrane Oxygenation, Cohort Studies, Health Care Costs, Hospital Mortality, Sepsis, Propensity Score
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