Background Parenteral nutrition (PN) is an important part of medical management of patients with a non-functioning and/or non-accessible gastrointestinal tract, but it is associated with some metabolic complications that prolong recovery from illness and can lead to increased length of hospital stay.
Purpose To determine the prevalence of metabolic complications in patients with PN and to study its association with different variables as well as its relationship with hospital stay and mortality.
Material and methods A retrospective observational study in a 330 bed referral hospital area was conducted. Inpatients who received PN during their hospital stay from September 2014 to August 2015 were included. Demographic (sex, age), clinical (diagnosis, weight, height) and analytical data (metabolic markers, electrolytes) were collected from the electronic medical record (Selene) and minimal basic data set, and information concerning PN (customised PN or premixed solutions and caloric, protein, carbohydrate and electrolyte content) was obtained from Kabisoft. Patients without analytical parameters required for the determination of metabolic complications were excluded. From the analytical data the presence of metabolic complications was determined. All statistical analyses were performed using statistical software SPSS V.23.0 and a p value of 0.05 was considered to be statistically significant.
Results 128 patients were included, with an average age of 67.4 years. 65.6% were men. At hospital admission, 47.7% of patients was diagnosed with digestive disease. The most prevalent chronic diseases were diabetes mellitus and solid tumours (17.2%). During the study period, 1223 PN were administered, 61.1% were three compartment premixed solutions. In terms of metabolic complications, 76.6% of patients had at least one of these complications and the most prevalent were hypokalaemia (49.2%), hyponatraemia (35.9%) and hyperglycaemia (31.3%). The statistical analysis revealed a significant association between the presence of metabolic complications, days with PN (p<0.001) and length of hospital stay (p=0.012).
Conclusion There was a high prevalence of metabolic complications associated with PN, resulting in increased length of hospital stay and hospital costs. As a result, compliance with clinical practice guidelines on starting and prescribing a PN as well as close monitoring of the patient to detect possible complications associated with nutritional support are necessary.
No conflict of interest
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