Early Initiation of Feeding Improves In-hospital outcomes in Acute Heart Failure

Nutrition support is increasingly recognized as a clinically relevant aspect of the intensive care treatment of cardiac surgery patients. Extensive data on early nutrition support for patients requiring critical care are available. However, whether early initiation of feeding could be beneficial for patients hospitalised for acute heart failure (HF) remains unclear. Therefore, researchers of the University of Tokyo conducted a study to compare outcomes of early and delayed initiation of feeding for hospitalized patients with acute HF.

It was a retrospective study conducted using a nationwide inpatient database (Diagnosis Procedure Combination database). Researchers included patients hospitalised for HF between January 2010 and March 2018. They performed the propensity score matching that created 29,153 pairs and instrumental variable analyses 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 two days after admission) and 29,178 patients (7%) received delayed initiation of feeding.

Upon analysis, researchers found that delayed initiation of feeding was associated with higher in-hospital mortality (odds ratio [OR], 1.34), longer hospital stay and higher incidence of pneumonia and sepsis. They also found similar findings in the instrumental variable analysis.

The authors concluded, "our analysis suggested a potential benefit of early initiation of feeding for in-hospital outcomes in hospitalised patients hospitalised for acute HF. Further investigations are required to confirm our results and to clarify the underlying mechanisms".

For further information:

https://www.ajconline.org/article/S0002-9149(21)00040-0/fulltext