title: Rates of adult acute inpatients documented as at risk of refeeding syndrome by dietitians.
abstract: OBJECTIVE
  Identification of Refeeding Syndrome (RFS) is vital for prevention and treatment of metabolic disturbances, yet no information exists that describes identification rates by dietitians in acute care. We aimed to describe rates and demographics of inpatients identified by dietitians as at-risk of RFS and factors associated with electrolyte levels post-dietetic assessment.
  
  
  METHODS
  Eligible participants were adult (≥ 18 yrs) acute care inpatients reviewed by dietitians between March 2012-February 2013 and not admitted to intensive care prior to first dietetic assessment. Patient information was sourced from medical charts. Chi-squared, t-tests and linear regression analyses were conducted.
  
  
  RESULTS
  Of 1661 eligible inpatients (55%F, 65 ± 18 yrs), 9% (n = 151) were documented as at-risk of RFS in the first dietetic medical chart entry. On average, patients identified with RFS-risk had four days greater hospital stay, were 13 kg lighter, more likely classified SGA C (36% vs. 7%), and on a modified diet (52% vs. 35%) than non-RFS patients (p < 0.05). Very low and low electrolyte values occurred within seven days post-dietetic assessment in 7% and 52%, respectively, of inpatients with RFS-risk. Regression analysis showed that electrolyte supplementation was positively associated (β = 0.145-0.594), and number of RFS-related risk factors negatively associated (β = -0.044-0.122), with potassium, magnesium and phosphate levels within seven days post-dietetic assessment (p < 0.05).
  
  
  CONCLUSIONS
  Nine percent of adult inpatients were documented as at-risk of RFS by dietitians. Identification of at-risk patients was in accordance with RFS guidelines. Electrolyte supplementation was positively associated with electrolyte levels post-assessment. Consistency of RFS-risk identification between dietitians requires determination.
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia. Electronic address: emma.owers@health.qld.gov.au.
authors.forename: Emma L
authors.initials: EL
authors.lastname: Owers
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia.
authors.forename: Anneli I
authors.initials: AI
authors.lastname: Reeves
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia.
authors.forename: Susan Y
authors.initials: SY
authors.lastname: Ko
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia.
authors.forename: Aleshia K
authors.initials: AK
authors.lastname: Ellis
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia.
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Huxtable
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia.
authors.forename: Sally A
authors.initials: SA
authors.lastname: Noble
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia.
authors.forename: Helen E
authors.initials: HE
authors.lastname: Porteous
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia.
authors.forename: Eli J
authors.initials: EJ
authors.lastname: Newman
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Josephson
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Roth
authors.affiliation: Queensland Health, Beaudesert Hospital, Nutrition & Dietetics, Beaudesert, QLD 4285, Australia.
authors.forename: Clare E
authors.initials: CE
authors.lastname: Byrne
authors.affiliation: Queensland Health, Logan Hospital, Nutrition & Dietetics, Meadowbrook, QLD 4131, Australia.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Palmer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D004573:Electrolytes / Q000008:administration & dosage / Q000097:blood; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008274:Magnesium / Q000097:blood; D008297:Male; D008875:Middle Aged; D064686:Nutritionists; D010710:Phosphates / Q000097:blood; D011188:Potassium / Q000097:blood; D055677:Refeeding Syndrome / Q000175:diagnosis*; D012307:Risk Factors
chemical_list: D004573:Electrolytes; D010710:Phosphates; D008274:Magnesium; D011188:Potassium
keywords: Adult; Electrolytes; Hospital; Identification; Malnutrition; Refeeding syndrome