Work

The impact of early nutritional support on in-hospital mortality in patients with sepsis caused by bacterial or viral infections: a retrospective cohort study

Year: 2025

Type: article

Abstract: BACKGROUND: The impact of pathogen type on the relationship between early nutritional support and prognosis in sepsis patients remains unclear. This study aims to evaluate the effect of early nutritional support on in-hospital mortality in patients with sepsis caused by viral or bacterial infections. MATERIALS AND METHODS: A retrospective cohort study was conducted, including adult patients with sepsis admitted to the intensive care unit (ICU) of Zhongda Hospital, Southeast University, between 2016 and 2023. Early nutritional support was defined as initiating nutritional support within 48 h of sepsis diagnosis. Patients were stratified based on pathogen type, and propensity score matching (PSM) and inverse probability weighting (IPW) were used to adjust for confounding factors. Logistic regression analysis was performed to assess the effect of early nutritional support on in-hospital mortality. RESULTS: A total of 2,278 patients with sepsis were included (119 viral and 2,159 bacterial). After adjustment, in the viral sepsis group, early nutritional support was associated with a lower in-hospital mortality compared to delayed support (25.0% vs. 30.0%, aOR 0.79, 95% CI 0.63-0.99, p = 0.046). In contrast, in the bacterial sepsis group, early nutritional support showed no significant benefit for in-hospital mortality (16.3% vs. 18.5%, aOR 1.02, 95% CI 0.98-1.06, p = 0.328). For bacterial sepsis, early support was associated with longer ICU length of stay and duration of mechanical ventilation among survivors. CONCLUSION: Early nutritional support may offer a potential survival benefit in patients with viral sepsis. Given the small size and borderline statistical significance, these findings should be interpreted with caution and require further validation through prospective randomized controlled trials.

Source: European journal of medical research

DOI: 10.1186/s40001-025-03454-x