Prevalence and risk factors for feeding intolerance in geriatric patients following nasogastric tube nutrition: a systematic review and meta-analysis.

AIM: To determine the prevalence of feeding intolerance and identify associated risk factors among older patients receiving nasogastric tube feeding.

METHODS

We conducted a comprehensive literature search in PubMed, Embase, Cochrane, and Web of Science databases from inception to October 23, 2023. Clinical studies involving participants aged ≥ 60 years who received nasogastric tube feeding and reported the prevalence or incidence of feeding intolerance were included.

RESULTS

Of 2187 records identified, four trials including 317 older adults were eligible for inclusion. The pooled proportion of diarrhea was 24% (95% CI 0.00 to 0.65), with substantial heterogeneity (I2 = 98.15%). After excluding one statistical outlier, the pooled proportion decreased to 3% (95% CI 0.00 to 0.12; I2 = 84.50%). Subgroup analyses suggested that geographic region might contribute to heterogeneity, whereas follow-up duration showed no clear effect. Beyond diarrhea, isolated vomiting events were reported (3.8%), whereas no cases of bloating or constipation were documented. Two studies reported a higher diarrhea rate in patients receiving intermittent compared with continuous nasogastric tube feeding.

CONCLUSION

This meta-analysis provides preliminary evidence that, among older patients receiving nasogastric tube feeding, the pooled proportion of diarrhea varied widely across studies and appears lower with continuous than with intermittent regimens. However, due to the small number of included studies and limited sample sizes, these findings should be interpreted with caution.