Table 2. Efficacy and Safety Outcomes by Group.
| Outcome | HCR (n = 60) | LCR (n = 51) | Difference (95% CI) |
|---|---|---|---|
| Efficacy outcomes, mean (SD) | |||
| Days to medical stability | 7.0 (7.0) | 10.0 (8.0) | −3.0 (−4.9 to −1.2)a |
| Days to restored heart rateb | 4.5 (6.0) | 8.0 (8.0) | −4.0 (−6.5 to −1.5)a |
| Weight gain, mean (SD), kg | 2.9 (1.6) | 2.2 (1.3) | 0.79 (0.2 to 1.3)a |
| Percentage of mBMI, mean (SD) | 5.4 (3.0) | 3.2 (5.7) | 2.3 (0.1 to 3.9)a |
| Weight change at day 1-2, mean (SD), percentage of mBMI | 0.38 (0.71) | −0.31 (0.77) | 0.7 (0.4 to 1.0)a |
| Safety indicators | |||
| Electrolyte abnormalities, No. (%)c | |||
| Hypophosphatemia (<3.0 mg/dL) | 4 (7) | 3 (6) | 1 (−8 to 10) |
| Hypomagnesemia (<3.5 mEq/L) | 7 (12) | 14 (28) | −16 (−31 to 1) |
| Hypokalemia (<1.8 mg/dL) | 3 (5) | 5 (10) | −5 (−15 to 5) |
| Electrolyte correction, No. (%)d | |||
| Phosphorus | 6 (10) | 2 (4) | 5 (−4 to 14) |
| Magnesium | 12 (20) | 10 (20) | 0.3 (−12 to 2) |
| Potassium | 5 (8) | 4 (8) | 0.4 (−9. to 10) |
| Day of electrolyte nadir, mean (SD) | |||
| Phosphorus | 4.6 (1.9) | 5.8 (2.5) | −1.2 (−2.0 to −0.4)a |
| Magnesium | 5.1 (2.5) | 6.2 (2.7) | −1.1 (−2.1 to −0.1)a |
| Potassium | 4.0 (2.7) | 4.8 (3.1) | −0.9 (−2.0 to 0.2) |
| Cost outcomes, mean (SD) | |||
| Length of stay, d | 8.0 (5.5) | 12.0 (6.0) | −4.0 (−6.1 to −1.9)a |
| Cost per participant, $ | 10 784 (7410) | 16 302 (8230) | −5518 (−8266 to −2770)a |
| Hospital charges per participant, $ | 38 112 (26 043) | 57 168 (30 486) | −19 056 (−28 819 to −9293)a |
Abbreviations: HCR, higher-calorie refeeding; LCR, lower-calorie refeeding; mBMI, 50th percentile body mass index for age and sex.
SI conversion factors: To convert phosphorus to millimoles per liter, multiply by 0.323; potassium to millimoles per liter, multiply by 1.0; and magnesium to millimoles per liter, multiply by 0.4114.
CI does not include zero indicating a difference between groups at significance level α = .05.
Heart rate restored to 45 beats/min or more for 24 hours in hospital, among 46 HCR and 42 LCR participants who presented with a heart rate of less than 45 beats/min (Table 1).
Electrolyte abnormalities that developed after initiation of refeeding treatment.
See eTable in Supplement 2 for electrolyte correction protocol, including dosage based on serum level.