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Effects of early enteral nutrition on patients after emergency gastrointestinal surgery: a propensity score matching analysis

Authors
 Seung Hwan Lee  ;  Ji Young Jang  ;  Hyung Won Kim  ;  Myung Jae Jung  ;  Jae Gil Lee 
Citation
 Medicine, Vol.93(28) : e323, 2014 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2014
Abstract
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.
Files in This Item:
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DOI
10.1097/MD.0000000000000323
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김형원(Kim, Hyung Won)
이승환(Lee, Seung Hwan) ORCID logo https://orcid.org/0000-0001-7325-8262
이재길(Lee, Jae Gil) ORCID logo https://orcid.org/0000-0002-1148-8035
장지영(Jang, Ji Young)
정명재(Jung, Myung Jae)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138586
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