Development and Validation of a Prediction Model for Enteral Feeding Intolerance in Critical Ill Patients: A Retrospective Cohort Study

ABSTRACT

Aim

To construct and validate a prediction model for enteral feeding intolerance in critically ill patients during the first 7 days of enteral feeding.

Design

A retrospective cohort study.

Methods

We reviewed the medical records of two intensive care units from January 2015 to August 2023, to develop a prediction model by univariate analysis and logistic regression analysis. Model's performance was evaluated through discrimination, calibration and decision curve analysis.

Results

This study involved a total of 471 patients, with an enteral feeding intolerance incidence rate of 35.7%. The prediction model comprised six variables, namely neurological disease, chronic gastrointestinal disease, Acute Physiological and Chronic Health Assessment II score, sedatives, acid suppressants and serum albumin. The model showed robust discrimination, calibration and clinical net benefit, indicating significant potential for practical application with readily available variables.

Conclusions

The model demonstrated strong predictive performance in assessing the risk of enteral feeding intolerance during the early stage of nutrition initiation.

Implications for the Profession and/or Patient Care

Enhancing clinicians' capacity to reduce the incidence of enteral feeding intolerance and improve patient outcomes.

Impact

The prediction model shows a good capacity to discriminate critically ill patients at risk of enteral feeding intolerance, is helpful to provide personalised care.

Reporting Method

TRIPOD + AI checklist.

Patient or Public Contribution

No patient or public contribution.

Trial Registration: https://www.chictr.org.cn/ ChiCTR2400090757

A meta‐analysis examining the impact of open surgical therapy versus minimally invasive surgery on wound infection in females with cervical cancer

Abstract

A meta-analysis study was executed to measure the effect of minimally invasive surgery (MIS) and open surgical management (OSM) on wound infection (WI) in female's cervical cancer (CC). A comprehensive literature study till February 2023 was applied and 1675 interrelated investigations were reviewed. The 41 chosen investigations enclosed 10 204 females with CC and were in the chosen investigations' starting point, 4294 of them were utilizing MIS, and 5910 were utilizing OSM. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were utilized to compute the value of the effect of MIS and OSM on WI in female's CC and by the dichotomous approaches and a fixed or random model. The MIS had significantly lower WI (OR, 0.23; 95% CI, 0.15–0.35, p < 0.001) with no heterogeneity (I ² = 0%) and postoperative aggregate complications (PACs) (OR, 0.49; 95% CI, 0.37–0.64, p < 0.001) in females with CC and compared OSM. However, MIS compared with OSM in females with CC and had no significant difference in pelvic infection and abscess (PIA) (OR, 0.59; 95% CI, 0.31–1.16, p = 0.13). The MIS had significantly lower WI, and PACs, though, had no significant difference in PIA in females with CC and compared with OSM. However, care must be exercised when dealing with its values because of the low sample size of some of the nominated investigations for the meta-analysis.