# The impact and predictive value of refeeding syndrome on the short-term prognosis of patients with severe stroke: a retrospective cohort study

## TL;DR

This study shows that refeeding syndrome worsens short-term outcomes in severe stroke patients and can help predict poor prognosis.

## Contribution

The study identifies refeeding syndrome as an independent risk factor for poor prognosis in severe stroke patients.

## Key findings

- RFS patients had higher rates of ALI, AKI, MV, mortality, and worse mRS scores compared to non-RFS patients.
- Serum phosphorus levels decreased after enteral nutrition in RFS patients.
- RFS had moderate predictive value for poor prognosis with an AUC of 0.678.

## Abstract

Refeeding syndrome (RFS) may have adverse effects on patients. However, the impact of RFS on the prognosis of severe stroke patients remain unclear. This study aims to explore the impact on short-term prognosis of patients with severe stroke.

A total of 305 patients were included for retrospective analysis. The electrolyte changes and short-term prognosis between RFS and Non-RFS (NRFS) groups of patients were compared. Besides, the risk factors for prognosis of patients and the predictive efficacy of RFS in patient prognosis were analyzed.

The new acute liver injury (ALI), new acute kidney injury (AKI), new mechanical ventilation (MV), mortality within 28 d, and mRS scores at the discharge were higher in the RFS group than in the NRFS group (p < 0.05). The serum phosphorus level in the RFS group decreased after EN compared to before EN (p < 0.05). The area under the ROC curve (AUC) of RFS for predicting poor prognosis in patients with severe stroke was 0.678, with a sensitivity of 64.7%, and a specificity of 61.4%.

RFS is an independent risk factor for the patient’s functional prognosis, therefore, medical staff should screen high-risk populations as early as possible and provide preventive treatment according to the guidelines.