Gastrointestinal Bleeding and Feeding Intolerance among Intubated Patients Receiving Enteral Nutrition Within versus After 24 Hours at Thasongyang Hospital, Tak Province

Abstract

This retrospective cohort study aimed to compare the incidence of gastrointestinal bleeding and feeding intolerance between critically ill patients who received enteral feeding within 24 hours and those who received enteral feeding after 24 hours following endotracheal intubation and to investigate associated factors. Data were collected from critically ill patients at Tha Song Yang Hospital, Tak Province, from January 1 to December 31, 2025. A total of 112 patients were included: 77 received enteral feeding within 24 hours and 35 received enteral feeding after 24 hours. Participants were selected using purposive sampling. Data were analyzed using descriptive and inferential statistics, including logistic regression, an independent t-test, a chi-square test, and Fisher’s exact test. Odds ratios (ORs) were also reported. The study was conducted from April to June 2026.

The incidence of gastrointestinal bleeding was 3.90% in patients who received enteral feeding within 24 hours and 8.57% in those who received feeding after 24 hours, with no statistically significant difference (RR=0.45, 95% CI=0.10–2.14, p=0.37). Feeding intolerance occurred in 16.88% and 34.29% of patients, respectively (RR=0.49, 95% CI=0.25–0.97, p=0.04). After adjustment for covariates, enteral feeding within 24 hours was associated with lower odds of feeding intolerance (adjusted OR=0.36, 95% CI=0.13–0.97, p=0.04). In conclusion, enteral feeding within 24 hours was associated with a lower occurrence of feeding intolerance, while there was no evidence of an increased incidence of gastrointestinal bleeding among patients receiving enteral feeding within 24 hours. These findings may provide preliminary evidence to support consideration of early enteral feeding in patients without clinical contraindications.