Table 2.
Univariate and multivariate analyses for optimal and non-optimal application of the 2014 and 2017 EN guidelines.
| 2014 French guidelines (n = 416) | 2017 American guidelines (n = 416) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Univariate analysisa | Multivariate analysisb | Univariate analysisa | Multivariate analysisb | |||||||
| Optimal EN, n = 88 (21%) | Non-optimal EN, n = 328 (79%) | p | OR (95% CI) | p | Optimal EN, n = 161 (39%) | Non-optimal EN, n = 255 (61%) | p | OR (95% CI) | p | |
| PIM 2, median (IQR) | 1.6 (0.8–4.5) | 2.6 (1–6.7) | 0.21 | 1.6 (0.8–4) | 3.4 (1–7.4) | 0.78 | ||||
| Chronic cardiac disease, n (%) | 32 (36) | 60 (18) | <0.001 | 0.5 (0.3–0.9) | 0.014 | 51 (32) | 41 (16) | <0.001 | 0.5 (0.3–0.9) | 0.019 |
| Chronic digestive disease, n (%) | 40 (45) | 84 (25) | <0.001 | 0.6 (0.4–1.0) | 0.075 | 67 (42) | 57 (22) | <0.001 | 0.6 (0.4–0.9) | 0.032 |
| Malnutrition, n (%) | 39 (44) | 112 (34) | 0.089 | 0.8 (0.5–1.3) | 0.39 | 72 (45) | 79 (31) | 0.006 | 0.7 (0.4–1.0) | 0.065 |
| EN interruption, median (IQR) | 0 (0–1) | 1 (0–2) | 0.12 | 0 (0–1) | 1 (0–2) | 0.004 | 1.1 (0.9–1.3) | 0.41 | ||
| Feeding intolerance, n (%) | 44 (50) | 151 (46) | 0.48 | 74 (46) | 120 (47) | 0.83 | ||||
| Invasive ventilation, n (%) | 32 (36) | 169 (51) | 0.014 | 1.2 (0.7–2.0) | 0.53 | 62 (38) | 138 (54) | 0.002 | 1.1 (0.7–1.8) | 0.61 |
| Non-invasive ventilation, n (%) | 45 (51) | 171 (52) | 0.91 | 82 (51) | 134 (53) | 0.74 | ||||
| Hemodynamic failure, n (%) | 2 (2) | 51 (15) | 0.004 | 5.3 (1.1–28.4) | 0.049 | 7 (4) | 46 (18) | <0.001 | 2.7 (1.1–7.5) | 0.047 |
| Paralytic agents, n (%) | 2 (2) | 25 (8) | 0.090 | 2.7 (0.6–12.9) | 0.22 | 4 (2.5) | 23 (9) | 0.013 | 2.9 (0.9–9.1) | 0.077 |
| Morphinic agents, maximum rate (mg kg−1 day−1), median (IQR) | 1.2 (0.6–2) | 1.5 (1–6) | 0.030 | 1 (0.9–1.1) | 0.92 | 1.2 (0.7–2) | 1.5 (1–7) | 0.002 | 1.0 (0.9–1.1) | 0.76 |
| Midazolam, maximum rate (mcg kg−1 min−1), median (IQR) | 1.7 (0.6–3) | 1.5 (0.5–3) | 0.65 | 1.5 (0.5–3) | 1.5 (0.7–3) | 0.67 | ||||
| Outcomes | ||||||||||
| Mortality at day 60, n (%) | 1 (4) | 31 (10) | 0.071 | 9 (6) | 25 (10) | 0.12 | ||||
| Length of stay in PICU (days), median (IQR) | 6 (3–11) | 5 (3–10) | 0.16 | 5 (3–10) | 5 (3–10) | 0.81 | ||||
| Energy intake received (kcal kg −1day−1), median (IQR) | 59.7 (41.8–73.5) | 25.4 (12.7–38.4) | <0.001 | 52.4 (40.0–66.2) | 18.4 (10.0–28.1) | <0.001 | ||||
| Time to initiate EN (h), median (IQR) | 10 (3–26) | 24 (9–53) | <0.001 | 11 (4–27) | 29 (12–58) | <0.001 | ||||
EN, enteral nutrition; OR, odds ratio; CI, confidence interval; PICU, pediatric intensive care unit; IQR, interquartile range; PIM 2, Pediatric Index of Mortality 2.
a
Mann–Whitney test for quantitative variables and chi-square for categorical variables.
b
Multivariate logistic regression for the risk of non-optimal application of guidelines.