| アブストラクト | BACKGROUND & AIMS: Guidelines recommend early parenteral nutrition for malnourished patients. However, the effectiveness of early parenteral nutrition in underweight patients has not been established. This study aimed to determine whether in-hospital outcomes were associated with early parenteral nutrition in underweight gastrointestinal surgery patients with short-term contraindications to early enteral nutrition. METHODS: We identified underweight adult gastrointestinal surgery patients with short-term contraindications to early enteral nutrition using the Japanese Diagnosis Procedure Combination database from July 2010 to March 2018. We performed propensity-score overlap weighting to compare in-hospital outcomes between patients with and without early parenteral nutrition. The primary outcome was length of hospital stay. The secondary outcomes were total hospitalization cost, hospital-acquired pneumonia, hospital-acquired urinary tract infection, central line-associated bloodstream infection, and all-cause 28-day in-hospital mortality. RESULTS: We identified 31,898 eligible patients. Early parenteral nutrition was associated with longer hospital stay (19.2 vs. 18.4 days; difference, 0.7 days; 95% CI, 0.1 to 1.4). There were no differences between the patients with and without early parenteral nutrition in total hospitalization cost (difference, US$60; 95% CI, -277 to 397), hospital-acquired pneumonia (risk difference, -0.11%; 95% CI, -0.78 to 0.55), hospital-acquired urinary tract infection (risk difference, 0.03%; 95% CI, -0.08 to 0.14), central line-associated bloodstream infection (risk difference, 0.08%; 95% CI, -0.02 to 0.18), and all-cause 28-day in-hospital mortality (risk difference, 0.31%; 95% CI, -0.07 to 0.69). CONCLUSIONS: Early parenteral nutrition for underweight gastrointestinal surgery patients with short-term contraindications to early enteral nutrition was associated with longer hospital stay. |
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| 投稿日 | 2021/5/25 |
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| 投稿者 | Otaka, Shunichi; Aso, Shotaro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo |
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| ジャーナル名 | Clinical nutrition ESPEN |
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| 組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.;Electronic address: shun-tky@umin.ac.jp.;Department of Biostatistics and Bioinformatics, The University of Tokyo, 7-3-1;Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. Electronic address:;asou-sin@umin.ac.jp.;Electronic address: ptmatsui-tky@umin.ac.jp.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.;Electronic address: kfushimi.hci@tmd.ac.jp.;Electronic address: yasunagah-tky@umin.ac.jp. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/34024556/ |
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