Premium
Clinical Impact of Prescribed Doses of Nutrients for Patients Exclusively Receiving Parenteral Nutrition in Japanese Hospitals: A Retrospective Cohort Study
Author(s) -
Sasabuchi Yusuke,
Ono Sachiko,
Kamoshita Satoru,
Tsuda Tomoe,
Kuroda Akiyoshi
Publication year - 2021
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.2033
Subject(s) - medicine , parenteral nutrition , retrospective cohort study , odds ratio , logistic regression , cohort , medical nutrition therapy , cohort study , pediatrics , emergency medicine
Background In patients receiving parenteral nutrition (PN), the association between nutrition achievement in accordance with nutrition guidelines and outcomes remains unclear. Our purpose was to assess the association between nutrition achievement and clinical outcomes, including in‐hospital mortality, activity of daily living (ADL), and readmission. Methods In this retrospective cohort study, data were extracted from an inpatient medical‐claims database at 380 acute care hospitals. This study included patients who underwent central venous catheter insertion between January 2009 and December 2018. Patients were classified into 3 groups: (1) target‐not‐achieved; (2) target‐partially‐achieved; and (3) target‐achieved. The target doses of energy, amino acids, and lipid were defined as ≥20 kcal/kg/day, ≥1.0 g/kg/day, and ≥2.5 g/day, respectively. To examine the effect of nutrition achievement on outcomes, a multivariable logistic regression analysis was performed. Results A total of 54,687 patients were included; of these, 21,383 patients were in the target‐not‐achieved group, 29,610 patients were in the target‐partially‐achieved group, and 3694 patients were in the target‐achieved group. The adjusted odds ratio (OR) (95% CI) for in‐hospital mortality was 0.69 (0.66–0.72) in the target‐partially‐achieved group and 0.47 (0.43–0.52) in the target‐achieved group with reference to the target‐not‐achieved group. The adjusted ORs for deteriorated ADL was 0.93 (0.85–1.01) in the target‐partially‐achieved group and 0.77 (0.65–0.92) in the target‐achieved group with reference to the target‐not‐achieved group. Readmission was not associated with nutrition achievement. Conclusion In‐hospital mortality was lower and deteriorated ADL was suppressed in patients whose PN management was in accordance with the nutrition guidelines.