Complications and risk factors of intermittent nasogastric/intermittent orogastric tube feeding in the rehabilitation ward: A retrospective study

Background & Aims: Intermittent nasogastric (ING)/intermittent orogastric (IOG) tube feeding is an intermittent tube feeding (ITF) method in which a catheter is sporadically placed through the mouth or nose into the stomach to administer nutrients with syringes. This method proves advantageous in rehabilitation wards, as it allows for bed release and training. However, detailed reports on this method are limited, and its safety remains controversial. This study aimed to investigate the incidence of complications and risk factors associated with ING/IOG tube feeding. Methods: This longitudinal cohort study included 135 patients who received ING/IOG tube feeding for all meals and were discharged from our hospital between October 2018 and September 2022. The incidence and prevalence of complications (diarrhea, vomiting, and pneumonia) during the first 28 days after admission were retrospectively investigated. Multiple logistic regression analysis was performed to analyze factors associated with complications. The explanatory variables selected were age, functional independence measure (FIM) motor scores, low body mass index (BMI) (<20 kg/m²), number of observation days, and disease as regulators. Results: Of 135 patients, 57 (42.2%) had complications; 20 (29.6%) had diarrhea, 20 experienced (14.8%) vomiting, and 9 (6.7%) developed pneumonia. The incidence of diarrhea was 3.2% and that of vomiting was 1.2%. Significant factors associated with complications were low BMI (odds ratio=2.497 [1.214–5.136]) and FIM motor scores (odds ratio=0.933 [0.872–0.999]). Conclusions: The incidences of diarrhea, vomiting, and pneumonia were not necessarily higher than those of other tube feeding methods reported previously. ING/IOG tube feeding is recommended with caution in patients with low BMI and FIM scores, which have been identified as risk factors for complications.