1Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
2Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
Copyright © 2022 The Korean Society of Critical Care Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conceptualization: WJJ. Data curation: GWK. Formal analysis: JHH, YIR. Methodology: SOH. Project administration: KCC. Visualization: GWK. Writing–original draft: GWK. Writing–review & editing: WJJ.
Values are presented as mean±standard deviation or number (%).
CKD: chronic kidney disease; ACS: acute coronary syndrome; COPD: chronic obstructive pulmonary disease; CVAD: cerebrovascular disease; PTE: pulmonary thromboembolism; VF: ventricular fibrillation; VT: ventricular tachycardia; PEA: pulseless electrical activity; BLS: basic life support; ACLS: advanced cardiovascular life support; AST: aspartate aminotransferase; ALT: alanine aminotransferase; BUN: blood urea nitrogen.
Variable |
Before matching (n=87) |
After matching (n=46) |
||||||
---|---|---|---|---|---|---|---|---|
Delayed nutrition support (n=39) | Early nutrition support (n=48) | Total (n=87) | P-value | Delayed nutrition support (n=23) | Early nutrition support (n=23) | Total (n=46) | P-value | |
Intensive care (day) | 5.8±5.7 | 8.0±7.5 | 7.0±6.8 | 0.116 | 5.9±5.2 | 9.7±7.7 | 7.8±6.8 | 0.052 |
Total hospital stay (day)a) | 7.2±7.4 | 17.9±30.3 | 13.1±23.6 | 0.022 | 5.0±5.5 | 13.0±40.3 | 9.0±29.5 | 0.078 |
APACHE II score | 21.4±8.6 | 15.8±7.5 | 18.3±8.4 | 0.002 | 20.8±9.8 | 17.5±7.9 | 19.2±9.0 | 0.209 |
Survival to discharge | 16 (41.0) | 43 (89.6) | 59 (67.8) | <0.001 | 9 (39.1) | 20 (86.9) | 29 (63.0) | <0.001 |
Good neurologic outcomeb) | 8 (20.5) | 34 (70.8) | 42 (48.3) | <0.001 | 4 (17.4) | 13 (56.5) | 17 (36.9) | 0.006 |
Complication | ||||||||
Aspiration pneumonia | 6 (15.4) | 8 (16.7) | 14 (16.1) | 1.000 | 5 (21.7) | 4 (17.4) | 9 (19.6) | 1.000 |
Regurgitation | 3 (7.7) | 4 (8.3) | 7 (8.0) | 1.000 | 2 (8.7) | 2 (8.7) | 4 (8.7) | 1.000 |
Ileus | 3 (7.7) | 1 (2.1) | 4 (4.6) | 0.321 | 1 (4.4) | 0 | 1 (2.2) | 1.000 |
Fever | 17 (43.6) | 22 (45.8) | 39 (44.8) | 1.000 | 11 (47.8) | 10 (43.5) | 21 (45.7) | 0.767 |
Hypoglycemia | 10 (25.6) | 15 (31.3) | 25 (28.7) | 0.638 | 5 (21.7) | 8 (34.8) | 13 (28.3) | 0.326 |
Hyperglycemia | 16 (41.0) | 14 (29.2) | 30 (34.5) | 0.266 | 9 (39.1) | 11 (47.8) | 20 (43.5) | 0.552 |
Variable | Before matching (n=87) |
After matching (n=46) |
||||||
---|---|---|---|---|---|---|---|---|
Delayed nutrition support (n=39) | Early nutrition support (n=48) | Total (n=87) | P-value | Delayed nutrition support (n=23) | Early nutrition support (n=23) | Total (n=46) | P-value | |
Age (yr) | 66.3±14.2 | 63.1±15.8 | 64.5±15.1 | 0.332 | 67.3±13.9 | 67.4±14.4 | 67.4±14.0 | 0.984 |
Male | 28 (71.8) | 32 (66.7) | 60 (69.0) | 0.648 | 16 (69.6) | 17 (73.9) | 33 (71.7) | 0.743 |
Body mass index (kg/m2) | 22.1±3.2 | 23.3±4.2 | 22.8±3.8 | 0.167 | 22.7±3.2 | 22.4±4.5 | 22.6±3.9 | 0.839 |
Weight (kg) | 62.0±10.8 | 63.3±14.4 | 62.7±12.9 | 0.845 | 62.7±10.3 | 60.2±12.0 | 61.4±11.2 | 0.455 |
Height (cm) | 167.0±8.1 | 164.2±9.6 | 165.4±9.1 | 0.233 | 166.1±8.3 | 163.3±6.9 | 164.7±7.7 | 0.227 |
Comorbidity | ||||||||
Hypertension | 14 (35.9) | 20 (41.7) | 34 (39.1) | 0.661 | 11 (47.8) | 11 (47.8) | 22 (47.8) | 1.000 |
Diabetes | 8 (20.5) | 11 (22.9) | 19 (21.8) | 1.000 | 4 (17.4) | 8 (34.8) | 12 (26.1) | 0.179 |
CKD | 3 (7.7) | 10 (20.8) | 13 (14.9) | 0.131 | 2 (8.7) | 6 (26.1) | 8 (17.4) | 0.243 |
Malignancy | 2 (5.1) | 2 (4.2) | 4 (4.6) | 1.000 | 1 (4.4) | 2 (8.7) | 3 (6.5) | 1.000 |
ACS | 6 (15.4) | 3 (6.3) | 9 (10.3) | 0.288 | 3 (13.0) | 1 (4.4) | 4 (8.7) | 0.608 |
COPD | 1 (2.6) | 3 (6.3) | 4 (4.6) | 0.624 | 0 | 3 (13.0) | 3 (6.5) | 0.233 |
CVAD | 4 (10.3) | 3 (6.3) | 7 (8.0) | 0.696 | 2 (8.7) | 1 (4.4) | 3 (6.5) | 1.000 |
PTE | 0 | 1 (2.1) | 1 (1.1) | 1.000 | 0 | 1 (4.4) | 1 (2.2) | 1.000 |
Hyperlipidemia | 8 (20.5) | 5 (10.4) | 13 (14.9) | 0.234 | 4 (17.4) | 3 (13.0) | 7 (15.2) | 1.000 |
Witnessed cardiac arrest | 31 (79.5) | 41 (85.4) | 72 (82.8) | 0.572 | 17 (73.9) | 20 (87.0) | 37 (80.4) | 0.459 |
First monitored rhythm | ||||||||
VF/pulseless VT | 12 (30.8) | 21 (44.7) | 33 (38.4) | 0.265 | 4 (17.4) | 6 (27.3) | 10 (22.2) | 0.491 |
PEA/asystole | 27 (69.2) | 26 (55.3) | 53 (61.6) | 19 (82.6) | 16 (72.7) | 35 (77.8) | ||
BLS (min) | 12.6± 13.9 | 10.3±12.0 | 11.3±12.9 | 0.404 | 15.2±13.9 | 8.2±10.1 | 11.7±12.5 | 0.060 |
ACLS (min) | 10.5±10.2 | 5.3±7.3 | 7.6±9.0 | 0.009 | 7.4±7.8 | 7.1±8.8 | 7.3±8.2 | 0.888 |
Targeted temperature management | 13 (14.9) | 26 (29.9) | 39 (44.8) | 0.082 | 9 (19.6) | 8 (17.4) | 17 (37.0) | 1.000 |
Hypothermia (33°C) | 5 (5.7) | 24 (27.6) | 29 (33.3) | 0.038 | 4 (8.7) | 6 (13.0) | 10 (21.7) | 0.722 |
Normothermia (36°C) | 8 (9.2) | 2 (2.3) | 10 (11.5) | <0.001 | 5 (10.9) | 2 (4.3) | 7 (15.2) | 0.414 |
Continuous renal replacement therapy | 10 (25.6) | 5 (10.4) | 15 (17.2) | 0.087 | 5 (21.7) | 2 (8.7) | 7 (15.2) | 0.414 |
Extracorporeal membrane oxygenation | 3 (7.7) | 0 | 3 (3.4) | 0.086 | 2 (8.7) | 0 | 2 (4.4) | 0.489 |
Coronary angiography | 6 (15.4) | 13 (27.1) | 19 (21.8) | 0.206 | 3 (13.0) | 6 (26.1) | 9 (19.6) | 0.459 |
Inotropic use | 35 (89.7) | 23 (47.9) | 58 (66.7) | <0.001 | 19 (82.6) | 20 (87.0) | 39 (84.8) | 1.000 |
Muscle relaxant use | 13 (33.3) | 27 (56.3) | 40 (46.0) | 0.051 | 9 (39.1) | 9 (39.1) | 18 (39.1) | 1.000 |
Initial laboratory value | ||||||||
Hemoglobin (g/dl) | 11.3±3.6 | 12.6±3.0 | 12.0±3.3 | 0.071 | 11.4±2.9 | 11.9±3.2 | 11.6±3.0 | 0.582 |
White blood cell (×109/L) | 13.7±7.2 | 14.0±4.7 | 13.9±6.6 | 0.660 | 12.5±7.2 | 13.1±5.4 | 12.8±6.3 | 0.750 |
AST (U/L) | 489±1,126 | 188±322 | 324±803 | 0.114 | 478.3±1251.3 | 184.3±425.3 | 331.3±935.9 | 0.295 |
ALT (U/L) | 261±528 | 139±200 | 193±385 | 0.185 | 165.8±370.8 | 114.3±226.2 | 139.5±303.1 | 0.580 |
BUN (mg/dl) | 32.9±28.6 | 32.4±27.7 | 32.6±27.9 | 0.944 | 27.8±16.9 | 36.1±29.4 | 31.9±24.1 | 0.250 |
Creatinine (mg/dl) | 2.1±2.2 | 2.6±3.5 | 2.40±3.0 | 0.430 | 2.0±1.5 | 2.3±2.2 | 2.1±1.9 | 0.639 |
C-reactive protein (mg/dl) | 3.51±8.61 | 1.89±4.69 | 2.61±6.74 | 0.499 | 5.2±10.9 | 3.1±6.5 | 4.1±9.0 | 0.436 |
Troponin I (pg/ml) | 83.08±156.53 | 177.31±547.03 | 135.07±420.22 | 0.286 | 70.9±160.6 | 41.1±113.6 | 56.0±138.4 | 0.471 |
Feeding volume within initial 5 days (ml) | 115±362 | 1,243±1,192 | 737±1,074 | <0.001 | 100.9±340.1 | 1,363.0±1,277.4 | 732.0±1123.1 | <0.001 |
Variable | Before matching (n=87) |
After matching (n=46) |
||||||
---|---|---|---|---|---|---|---|---|
Delayed nutrition support (n=39) | Early nutrition support (n=48) | Total (n=87) | P-value | Delayed nutrition support (n=23) | Early nutrition support (n=23) | Total (n=46) | P-value | |
Intensive care (day) | 5.8±5.7 | 8.0±7.5 | 7.0±6.8 | 0.116 | 5.9±5.2 | 9.7±7.7 | 7.8±6.8 | 0.052 |
Total hospital stay (day) |
7.2±7.4 | 17.9±30.3 | 13.1±23.6 | 0.022 | 5.0±5.5 | 13.0±40.3 | 9.0±29.5 | 0.078 |
APACHE II score | 21.4±8.6 | 15.8±7.5 | 18.3±8.4 | 0.002 | 20.8±9.8 | 17.5±7.9 | 19.2±9.0 | 0.209 |
Survival to discharge | 16 (41.0) | 43 (89.6) | 59 (67.8) | <0.001 | 9 (39.1) | 20 (86.9) | 29 (63.0) | <0.001 |
Good neurologic outcome |
8 (20.5) | 34 (70.8) | 42 (48.3) | <0.001 | 4 (17.4) | 13 (56.5) | 17 (36.9) | 0.006 |
Complication | ||||||||
Aspiration pneumonia | 6 (15.4) | 8 (16.7) | 14 (16.1) | 1.000 | 5 (21.7) | 4 (17.4) | 9 (19.6) | 1.000 |
Regurgitation | 3 (7.7) | 4 (8.3) | 7 (8.0) | 1.000 | 2 (8.7) | 2 (8.7) | 4 (8.7) | 1.000 |
Ileus | 3 (7.7) | 1 (2.1) | 4 (4.6) | 0.321 | 1 (4.4) | 0 | 1 (2.2) | 1.000 |
Fever | 17 (43.6) | 22 (45.8) | 39 (44.8) | 1.000 | 11 (47.8) | 10 (43.5) | 21 (45.7) | 0.767 |
Hypoglycemia | 10 (25.6) | 15 (31.3) | 25 (28.7) | 0.638 | 5 (21.7) | 8 (34.8) | 13 (28.3) | 0.326 |
Hyperglycemia | 16 (41.0) | 14 (29.2) | 30 (34.5) | 0.266 | 9 (39.1) | 11 (47.8) | 20 (43.5) | 0.552 |
Variable | Before matching (n=87) |
After matching (n=46) |
||
---|---|---|---|---|
Relative risk | 95% CI | Relative risk | 95% CI | |
Aspiration pneumonia | 1.05 | 0.55–2.03 | 0.95 | 0.19–1.26 |
Regurgitation | 1.05 | 0.43–2.55 | 1.09 | 0.84–1.20 |
Ileus | 0.58 | 0.31–1.07 | 0.96 | 0.88–1.04 |
Fever | 1.01 | 0.63–1.61 | 0.92 | 0.54–1.57 |
Hypoglycemia | 1.08 | 0.64–1.83 | 1.20 | 0.83–1.73 |
Hyperglycemia | 0.76 | 0.48–1.20 | 1.17 | 0.70–1.94 |
Good neurologic outcome | 3.62 | 1.88–6.95 | 1.90 | 1.15–3.14 |
Survival to discharge | 3.03 | 1.93–4.76 | 4.67 | 1.55–14.09 |
Values are presented as mean±standard deviation or number (%). CKD: chronic kidney disease; ACS: acute coronary syndrome; COPD: chronic obstructive pulmonary disease; CVAD: cerebrovascular disease; PTE: pulmonary thromboembolism; VF: ventricular fibrillation; VT: ventricular tachycardia; PEA: pulseless electrical activity; BLS: basic life support; ACLS: advanced cardiovascular life support; AST: aspartate aminotransferase; ALT: alanine aminotransferase; BUN: blood urea nitrogen.
Values are presented as mean±standard deviation or number (%) unless otherwise indicated. APACHE: Acute Physiology and Chronic Health Evaluation. Median±standard deviation; Cerebral performance category ≤2.
CI: confidence interval.