Serum potassium levels as an independent predictor of unplanned enteral nutrition discontinuation in older adults with gastroesophageal reflux disease

Abstract

Background & aims

Enteral nutrition in older adults is often associated with intolerance, a phenomenon not well-understood in the context of gastroesophageal reflux disease (GERD). This observational study aimed to evaluate serum potassium levels as an independent prognostic factor for unplanned enteral nutrition discontinuation in older adults with GERD.

Methods

We conducted a retrospective analysis of 213 consecutive patients with GERD who received enteral nutrition at our institution from April 2018 to March 2023. The dietary assessment involved extracting relevant nutritional information from the patients' medical records. The incidence of enteral nutrition discontinuation due to complications was monitored over a 30-day period after initiation.

Results

Patients were categorized into three groups based on initial serum potassium levels: low (<4.0 mmol/L), intermediate (4.0–4.5 mmol/L), and high (≥4.5 mmol/L). During the follow-up, 35 % of patients experienced events leading to the discontinuation of enteral nutrition. Higher potassium levels correlated with an increased risk of unplanned discontinuation of enteral nutrition (log-rank P = 0.002). Multivariate Cox proportional hazards analysis identified serum potassium level as an independent predictor of unplanned discontinuation (hazard ratio: 1.700 [95 % confidence interval: 1.100–2.627] per 1 mmol/L, P = 0.017).

Conclusions

Serum potassium level is a robust independent predictor of unplanned enteral nutrition discontinuation in older adults with GERD. Our findings suggest that monitoring and adjusting potassium levels may be essential for improving outcomes in this vulnerable population.