Clinical effects and medical costs of introducing early enteral nutrition by placing a registered dietitian at an emergency and critical care center

Abstract

Purpose: Not many emergency and critical centers have a registered dietitian (RD) in place in Japan, and the time to initiation of enteral nutrition is reportedly longer in Japan than overseas. We evaluated the clinical effects and medical costs of introducing early enteral nutrition through the placement of a registered dietitian (RD) in an emergency and critical care center.

Subjects and Methods: Patients who were admitted to our emergency and critical care center and could not take oral nutrition for ≥ 5 days were enrolled in the study. To investigate the effect of intervention afforded by placing the RD, patients were divided into two groups and compared: those who were admitted before the RD was placed (NRD group; n = 17, April 1, 2016 to May 31, 2017) and those who were admitted after the placement (RD group; n=18 patients, June 1, 2017 to March 31).

Results: The RD group had significantly shorter times to initiation of enteral nutrition and resumption of oral feeding, and significantly lower costs of parenteral infusion solution and antibiotics than the NRD group.

Conclusion: Placing an RD in the emergency and critical care center was associated with early initiation of enteral nutrition and resumption of oral feeding and lower antibiotic and medical costs.