Clinical nutrition (Edinburgh, Scotland) · 2026
Incidence and risk factors of refeeding syndrome in critically ill patients: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Xie Haohao, Hao Tian, Niu Wenxiu, Jia Donghui, Zhang Lin, Qi Ruirui, Han Xiaomeng, Wang Hengyang, Fan Wei, Cao Judong, Zhang Zhigang
Аннотация
BACKGROUND & AIMS: Refeeding syndrome (RFS) is characterized by electrolyte and metabolic disturbances that may occur following the initiation of nutritional support. Given the potential for these disturbances to contribute to clinically important complications, there is substantial interest in ensuring timely recognition of RFS and identifying patients at increased risk. This systematic review and meta-analysis aimed to systematically evaluate the incidence and risk factors of RFS in critically ill patients to support risk stratification and optimize nutritional management.
METHODS: This study was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420261363559). A comprehensive search of PubMed, Embase, Cochrane Library, CINAHL, CNKI, Wanfang, VIP, and CBM databases was performed from inception to January 2026. Study quality was assessed using the Newcastle-Ottawa Scale, and meta-analysis was performed using Stata 18.0.
RESULTS: A total of 49 studies involving 24,778 critically ill patients were included. The pooled incidence of RFS was 35% (95% CI: 27%-44%), with substantial heterogeneity across studies. Nineteen significant factors were identified across 31 studies. Factors associated with RFS included older age, markers of greater disease severity, indicators of poor nutritional status, diabetes mellitus, mechanical ventilation, and several feeding-related exposures, including higher caloric and protein intake, initiation of feeding within 48 h of ICU admission, feeding rates >50 mL/h, and the use of parenteral nutrition.
CONCLUSIONS: This systematic review and meta-analysis highlights the relatively high incidence and multifactorial nature of RFS among critically ill patients. The findings underscore the importance of early risk assessment, careful monitoring during nutritional rehabilitation, and individualized nutritional strategies tailored to patients' metabolic risk profiles. Future research should focus on standardized diagnostic criteria and prospective validation to improve prevention and management.
METHODS: This study was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420261363559). A comprehensive search of PubMed, Embase, Cochrane Library, CINAHL, CNKI, Wanfang, VIP, and CBM databases was performed from inception to January 2026. Study quality was assessed using the Newcastle-Ottawa Scale, and meta-analysis was performed using Stata 18.0.
RESULTS: A total of 49 studies involving 24,778 critically ill patients were included. The pooled incidence of RFS was 35% (95% CI: 27%-44%), with substantial heterogeneity across studies. Nineteen significant factors were identified across 31 studies. Factors associated with RFS included older age, markers of greater disease severity, indicators of poor nutritional status, diabetes mellitus, mechanical ventilation, and several feeding-related exposures, including higher caloric and protein intake, initiation of feeding within 48 h of ICU admission, feeding rates >50 mL/h, and the use of parenteral nutrition.
CONCLUSIONS: This systematic review and meta-analysis highlights the relatively high incidence and multifactorial nature of RFS among critically ill patients. The findings underscore the importance of early risk assessment, careful monitoring during nutritional rehabilitation, and individualized nutritional strategies tailored to patients' metabolic risk profiles. Future research should focus on standardized diagnostic criteria and prospective validation to improve prevention and management.