[Propensity score matching analysis of the effect of early enteral nutrition on clinical prognosis in patients with severe pneumonia].

Authors

Rui Zhang, Bo Liu, Yuqin Xiao, Tingting Zeng, Houqiang Huang, Silin Zheng, Min Huang

Published in

Zhonghua wei zhong bing ji jiu yi xue. Volume 38. Issue 5. Pages 552-557.

Abstract

To explore the impact of early enteral nutrition (EN) on clinical prognosis in patients with severe pneumonia via propensity score matching (PSM).
This retrospective cohort study enrolled patients diagnosed with severe pneumonia who received EN treatment in the Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Southwest Medical University, from January 2023 to March 2025. All participants were categorized into the ≤24-hour EN group and the >24-hour EN group based on the timing of EN initiation. PSM was performed to balance baseline characteristics between the two groups. Collected clinical variables included baseline demographic and clinical characteristics, nutritional status indicators [albumin (Alb), prealbumin (PA)], inflammatory markers [C-reactive protein (CRP)], incidence of gastrointestinal complications, pulmonary oxygenation parameters [arterial oxygen saturation (SaO₂), oxygenation index (PaO₂/FiO₂), arterial partial pressure of carbon dioxide (PaCO₂)], body temperature, and Barthel index score. Prognostic outcomes, including mechanical ventilation duration, respiratory intensive care unit (RICU) stay length, total hospital stay, hospitalization costs, and in-hospital mortality, were further compared between the two matched groups.
A total of 237 patients with severe pneumonia who received EN therapy were initially included in this study. After PSM, 203 patients were finally enrolled, including 86 patients in the ≤24-hour EN group and 117 patients in the >24-hour EN group. No significant differences were observed in baseline characteristics between the two matched groups, with all standardized mean differences (SMDs) of covariates less than 0.2. At admission, there were no statistically significant intergroup differences in Alb, PA, CRP, SaO₂, PaO₂/FiO₂, PaCO₂, body temperature, Barthel index score, overall incidence of gastrointestinal complications, hospitalization costs, or in-hospital mortality. Prior to discharge, no significant differences were found in Alb, PA, SaO₂, PaO₂/FiO₂, PaCO₂, body temperature, and Barthel index score between the two groups. However, patients in the ≤24-hour EN group exhibited a significantly lower discharge CRP level [mg/L: 26.74 (9.55, 68.28) vs. 42.56 (13.99, 92.20)], as well as shorter duration of mechanical ventilation [hours: 5 (2, 9) vs. 7 (3, 14)], RICU stay [days: 7 (3, 12) vs. 11 (5, 17)], and total hospital stay [days: 13 (8, 21) vs. 17 (10, 27)], all P<0.05.
Initiation of enteral nutrition within 24 hours after admission is associated with lower inflammatory levels and shorter duration of mechanical ventilation, RICU stay, and total hospital length of stay, which can effectively alleviate inflammation and improve clinical prognosis in patients with severe pneumonia.

PMID:
42427328
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

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