The investigators then adjusted the results for age, gender, severity of illness, medical vs surgical diagnosis, and degree of malnutrition. Following adjustment for these factors, they report that patients in the postimplementation group were more likely to receive enteral nutrition. In addition, adjusting for other variables (such as age, gender, simplified acute physiology II score, admission diagnosis, baseline nutritional class, and type of nutrition support), the investigators report that patients in the postimplementation group received fewer days of mechanical ventilation. Interestingly, the risk of death was lower in patients who received enteral vs parenteral nutrition. However, parenteral nutrition was utilized in sicker patients. Although a variety of factors may have predicted use of enteral nutrition in this study, we do not believe that they should be used to adjust the results. There is little physiologic reason that most of these factors would affect the use of enteral nutrition, and in our experience do not predict the success of enteral feeding. Sicker and malnourished patients are more likely to benefit from enteral feeding than less sick or severely ill patients. In our experience, surgical patients tolerate enteral feeding as well as medical patients (and many times better depending on the diagnosis).