The risk factors for refeeding hypophosphatemia in patients admitted to the intensive care unit after surgical emergency abdominal surgery

Rationale: Refeeding syndrome is a metabolic disorder that occurs when a person resumes eating after a prolonged fast. Surgical patients may be at increased risk for this refeeding syndrome due to the duration of the surgical fast. The aim of this study is to determine the incidence of refeeding hypophosphatemia in surgical emergency abdominal surgery patients in the intensive care unit and to evaluate the risk factors for this syndrome. Methods: We retrospectively analyzed the electronic medical records of 232 adult patients admitted to the intensive care unit after emergency abdominal surgery from January 1, 2018, to December 31, 2022. After excluding patients who did not have a preoperative phosphate laboratory test, patients whose preoperative phosphate level was already below 0.065mmol/L, and patients who started oral feeding within 48 hours after surgery, 155 patients were enrolled. Results: The mean patient age was 70.3 ± 15.0 years, and sex (male) was 80 (51.6%). The in-hospital mortality was 34 (21.9%). The mean operation time was 133 ± 75 minute. The rate of refeeding hypophosphatemia after emergency abdominal surgery was 47 (30.3%). In bivariate analysis, Body mass index < 18 kg/m2, serum calcium level performed in the ER was significantly different in the control and refeeding hypophosphatemia groups. In logistic regression analysis, Body mass index ≤ 18 kg/m2 and serum calcium level performed in the ER were independent factor associated with refeeding hypophosphatemia in patients admitted to the intensive care unit after emergency abdominal surgery. Conclusion: The Patients with BMI ≤ 18 kg/m2 and low serum calcium levels in the ER may be risk factors for refeeding hypophosphatemia during ICU admission after abdominal emergency surgery. Disclosure of Interest: None declared