Early enteral nutrition may not affect mortality rates when analyzed using propensity score matching. However, our findings indicate that early enteral nutrition is associated with shorter ICU stays and a lower incidence of severe acute kidney injury (AKI).

Notably, subgroup analysis indicates that septic patients with lower lactate levels may derive greater benefit from early enteral nutrition.

Considering the potential limitations of the propensity score method, additional randomized trials are necessary to validate the benefits of early enteral nutrition.

Among 1,111 patients, 786 (70.7%) were in the early EN group and 325 (29.3%) were in the delayed EN group. Before propensity score matching, the early EN group demonstrated lower mortality (crude OR = 0.694; 95% CI: 0.514–0.936; p = 0.018) and shorter ICU stays (8.3 [5.2, 12.3] vs. 10.0 [7.5, 14.2] days; p < 0.001).

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