Abstract:Objective To explore the occurrence and influencing factors of feeding intolerance during enteral nutrition support in elderly patients so as to provide guidance for prevention of feeding intolerance in elderly patients. Methods One hundred and seventeen elderly patients who were hospitalized and received enteral nutrition support in Western Theater General Hospital from January 2020 to January 2023 were selected as the study subjects. According to feeding tolerance during enteral nutrition support, the patients were divided into the tolerance group and the intolerance group. The general data, enteral nutrition support treatment and other relevant treatment data were compared between the two groups, and the factors influencing feeding intolerance during enteral nutrition support in the elderly patients were analyzed by multivariate logistic regression model. Results Among the 117 elderly patients enrolled into this study, 51 cases had feeding intolerance during enteral nutrition support, with the incidence rate of 43.59%. The proportions of patients with age ≥ 70 years, fasting time ≥ 4 d, Acute Physiology and Chronic Health EvaluationⅡ(APACHE-Ⅱ) score ≥ 20 points, hypoproteinemia, nutrient solution penetration concentration ≥ 330 mmol/L, mechanical ventilation therapy, ≥ 2 types of antibacterial drugs and mild hypothermia treatment were higher in the intolerance group than in the tolerance group, showing statistically significant differences (all P<0.05). But the proportion of dietary fiber addition was lower in the intolerance group (19.61%) than in the tolerance group (48.48%), with a statistically significant difference (P<0.05). Multivariate logistic regression analysis displayed that age ≥70 years (OR=2.038, 95%CI:1.342-3.094), fasting time ≥4 d(OR=3.074, 95%CI:1.704-5.545), APACHE-II score ≥ 20 points (OR=2.489, 95%CI:1.464-4.234), nutrient solution penetration concentration ≥330 mmol/L (OR=1.848, 95%CI:1.194-2.861), mechanical ventilation therapy (OR=4.336, 95%CI:1.838-10.232), use of ≥ 2 types of antibacterial drugs (OR=2.550, 95%CI:1.117-5.819) and mild hypothermia therapy (OR=2.646, 95%CI:1.201-5.829) were all independent risk factors for feeding intolerance during enteral nutrition support in the elderly patients, while dietary fiber addition (OR=0.161, 95%CI:0.063-0.415) was the protective factor (P<0.05). Conclusion The incidence rate of feeding intolerance during enteral nutrition support in the elderly is high, and there are many influencing factors. Conducting timely assessment and intervention can prevent feeding intolerance to a certain extent.
冉蕾, 向英, 王璋. 老年肠内营养支持期间喂养不耐受发生率及影响因素分析[J]. 实用预防医学, 2024, 31(4): 440-444.
RAN Lei, XIANG Ying, WANG Zhang. Incidence rate of feeding intolerance during enteral nutrition support and its influencing factors in the elderly. , 2024, 31(4): 440-444.