{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:15:37Z","timestamp":1788156937235,"version":"build-2803163510"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Refeeding syndrome (RFS) is a serious metabolic complication that may increase mortality in patients receiving enteral nutrition (EN). This study aims to investigate the incidence, risk factors of RFS within the ASPEN-defined 5-days window in critically ill patients receiving EN, and to evaluate its association with prolonged ICU length of stay and ICU mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-center prospective observational study was conducted in the emergency intensive care unit. Electrolyte and biochemical analysis were collected at admission and on days 3 and 5 of EN. Data on ICU length of stay and ICU mortality were collected. Univariate and multivariate Firth\u2019s penalized logistic regression analyses were used to identify risk factors for RFS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 294 patients were enrolled. The incidence of RFS was 62.9% (185\/294) on day 3 and 71.4% (210\/294) on day 5 of EN (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Overall ICU mortality was 12.9% (38\/294). Moderate\/severe RFS was associated with significantly higher ICU mortality compared with the combined mild\/no-RFS group on day 3 (OR = 2.14, 95% CI: 1.06\u20134.28,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.036) and day 5 (OR = 2.47, 95% CI: 1.22\u20134.99,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.014). Multivariate analyses identified baseline serum magnesium, phosphate, and potassium as independent risk factors of RFS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Refeeding syndrome incidence in critically ill patients receiving EN remains high, with progressive elevation during the first 5 days. Patients who developed moderate\/severe RFS on days 3 and 5 had significantly higher ICU mortality than those mild\/no-RFS patients. Baseline serum phosphorus, potassium, and magnesium were risk factors of RFS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1923682","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:40:02Z","timestamp":1788154802000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence, risk factors and outcomes of refeeding syndrome in critically ill patients receiving enteral nutrition: a prospective observational study"],"prefix":"10.3389","volume":"13","author":[{"given":"Linfang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Emergency, Affiliated Hospital of Jiangnan University, Wuxi","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihui","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Emergency, Affiliated Hospital of Jiangnan University, Wuxi","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Emergency, Affiliated Hospital of Jiangnan University, Wuxi","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Emergency, Affiliated Hospital of Jiangnan University, Wuxi","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongrong","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Emergency, Jiangnan University Medical Center, Wuxi","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.nut.2016.05.016","article-title":"Revisiting the refeeding 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