| アブストラクト | 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. |
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| ジャーナル名 | The American journal of cardiology |
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| 投稿日 | 2021/1/18 |
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| 投稿者 | 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 |
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| 組織名 | The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan;;The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.;Electronic address: hidehikaneko-circ@umin.ac.jp.;The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.;The Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan; The Department of Health Services;Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.;Department of Clinical Laboratory, Mie University Hospital, Mie, Japan.;Department of Medical Science and Cardiorenal Medicine, Yokohama City University;Graduate School of Medicine, Yokohama, Japan.;The Department of Rehabilitation, School of Allied Health Sciences, Kitasato;University, Kanagawa, Japan.;The Department of Health Services Research, The University of Tokyo, Tokyo,;Japan.;Health, The University of Tokyo, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33454342/ |
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