Early Initiation of Feeding and In-Hospital Outcomes in Patients Hospitalized for Acute Heart Failure
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 feed...
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| Veröffentlicht in: | The American journal of cardiology 2021-04, Vol.145, p.85-90 |
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| creator | Kaneko, Hidehiro Itoh, Hidetaka Morita, Kojiro Sugimoto, Tadafumi Konishi, Masaaki Kamiya, Kentaro Kiriyama, Hiroyuki Kamon, Tatsuya Fujiu, Katsuhito Michihata, Nobuaki Jo, Taisuke Takeda, Norifumi Morita, Hiroyuki Yasunaga, Hideo Komuro, Issei |
| description | 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 variable analysis also showed patients with delayed initiation of feeding had higher in-hospital mortality (odds ratio 1.34; 95% confidence interval 1.28 to 1.40). In conclusion, our analysis suggested a potential benefit of early initiation of feeding for in-hospital outcomes in hospitalized patients hospitalized for acute HF. Further investigations are required to confirm our results and to clarify the underlying mechanisms. |
| doi_str_mv | 10.1016/j.amjcard.2020.12.082 |
| format | Article |
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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 variable analysis also showed patients with delayed initiation of feeding had higher in-hospital mortality (odds ratio 1.34; 95% confidence interval 1.28 to 1.40). In conclusion, our analysis suggested a potential benefit of early initiation of feeding for in-hospital outcomes in hospitalized patients hospitalized for acute HF. Further investigations are required to confirm our results and to clarify the underlying mechanisms.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2020.12.082</identifier><identifier>PMID: 33454342</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject><![CDATA[Acute Disease ; Aged ; Aged, 80 and over ; Anesthesia ; Aorta ; Balloon treatment ; Cohort Studies ; Complications ; Confidence intervals ; Congestive heart failure ; Enteral Nutrition - methods ; Extracorporeal Membrane Oxygenation - statistics & numerical data ; Feeding ; Female ; Health Care Costs - statistics & numerical data ; Heart failure ; Heart Failure - therapy ; Hemodialysis ; Hospital Mortality ; Hospitalization ; Humans ; Intensive care ; Intra-Aortic Balloon Pumping - statistics & numerical data ; Intubation ; Intubation, Intratracheal - statistics & numerical data ; Japan - epidemiology ; Length of Stay - statistics & numerical data ; Male ; Matching ; Mortality ; Nutrition ; Oxygenation ; Patients ; Pneumonia ; Pneumonia - epidemiology ; Propensity Score ; Renal Dialysis - statistics & numerical data ; Retrospective Studies ; Sensitivity analysis ; Sepsis ; Sepsis - epidemiology ; Standard deviation ; Time Factors]]></subject><ispartof>The American journal of cardiology, 2021-04, Vol.145, p.85-90</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><rights>2021. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c374t-25463a39e7bb24aae7b076f55a126a8f3d08235fe426f4f92c02ce4d071926843</citedby><cites>FETCH-LOGICAL-c374t-25463a39e7bb24aae7b076f55a126a8f3d08235fe426f4f92c02ce4d071926843</cites><orcidid>0000-0002-2306-0669 ; 0000-0002-7706-9511 ; 0000-0003-4818-3347</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2503892480?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33454342$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kaneko, Hidehiro</creatorcontrib><creatorcontrib>Itoh, Hidetaka</creatorcontrib><creatorcontrib>Morita, Kojiro</creatorcontrib><creatorcontrib>Sugimoto, Tadafumi</creatorcontrib><creatorcontrib>Konishi, Masaaki</creatorcontrib><creatorcontrib>Kamiya, Kentaro</creatorcontrib><creatorcontrib>Kiriyama, Hiroyuki</creatorcontrib><creatorcontrib>Kamon, Tatsuya</creatorcontrib><creatorcontrib>Fujiu, Katsuhito</creatorcontrib><creatorcontrib>Michihata, Nobuaki</creatorcontrib><creatorcontrib>Jo, Taisuke</creatorcontrib><creatorcontrib>Takeda, Norifumi</creatorcontrib><creatorcontrib>Morita, Hiroyuki</creatorcontrib><creatorcontrib>Yasunaga, Hideo</creatorcontrib><creatorcontrib>Komuro, Issei</creatorcontrib><title>Early Initiation of Feeding and In-Hospital Outcomes in Patients Hospitalized for Acute Heart Failure</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>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 variable analysis also showed patients with delayed initiation of feeding had higher in-hospital mortality (odds ratio 1.34; 95% confidence interval 1.28 to 1.40). In conclusion, our analysis suggested a potential benefit of early initiation of feeding for in-hospital outcomes in hospitalized patients hospitalized for acute HF. Further investigations are required to confirm our results and to clarify the underlying mechanisms.</description><subject>Acute Disease</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia</subject><subject>Aorta</subject><subject>Balloon treatment</subject><subject>Cohort Studies</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Congestive heart failure</subject><subject>Enteral Nutrition - methods</subject><subject>Extracorporeal Membrane Oxygenation - statistics & numerical data</subject><subject>Feeding</subject><subject>Female</subject><subject>Health Care Costs - statistics & numerical data</subject><subject>Heart failure</subject><subject>Heart Failure - therapy</subject><subject>Hemodialysis</subject><subject>Hospital Mortality</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Intra-Aortic Balloon Pumping - statistics & numerical data</subject><subject>Intubation</subject><subject>Intubation, Intratracheal - 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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 variable analysis also showed patients with delayed initiation of feeding had higher in-hospital mortality (odds ratio 1.34; 95% confidence interval 1.28 to 1.40). In conclusion, our analysis suggested a potential benefit of early initiation of feeding for in-hospital outcomes in hospitalized patients hospitalized for acute HF. Further investigations are required to confirm our results and to clarify the underlying mechanisms.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33454342</pmid><doi>10.1016/j.amjcard.2020.12.082</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-2306-0669</orcidid><orcidid>https://orcid.org/0000-0002-7706-9511</orcidid><orcidid>https://orcid.org/0000-0003-4818-3347</orcidid></addata></record> |
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| subjects | Acute Disease Aged Aged, 80 and over Anesthesia Aorta Balloon treatment Cohort Studies Complications Confidence intervals Congestive heart failure Enteral Nutrition - methods Extracorporeal Membrane Oxygenation - statistics & numerical data Feeding Female Health Care Costs - statistics & numerical data Heart failure Heart Failure - therapy Hemodialysis Hospital Mortality Hospitalization Humans Intensive care Intra-Aortic Balloon Pumping - statistics & numerical data Intubation Intubation, Intratracheal - statistics & numerical data Japan - epidemiology Length of Stay - statistics & numerical data Male Matching Mortality Nutrition Oxygenation Patients Pneumonia Pneumonia - epidemiology Propensity Score Renal Dialysis - statistics & numerical data Retrospective Studies Sensitivity analysis Sepsis Sepsis - epidemiology Standard deviation Time Factors |
| title | Early Initiation of Feeding and In-Hospital Outcomes in Patients Hospitalized for Acute Heart Failure |
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