Parenteral nutrition use at a university hospital. Factors associated with inappropriate use

To evaluate the appropriateness of parenteral nutrition in hospital inpatients, we retrospectively reviewed the medical record of every third consecutive patient receiving parenteral nutrition admitted to a university hospital over 10 months. Of 186 patients, 71 (38%) were given this nutritional support for 7 days or fewer (short-term use). Patients who received it exclusively through peripheral catheters were more likely to receive it short term. Among 72 patients receiving it perioperatively, those who were given support for uncomplicated surgical procedures or procedures complicated by postoperative ileus were more likely to receive it short term. We conclude that a substantial amount of parenteral nutrition use results in brief durations of support for conditions that are uncomplicated or self-limited. We have identified factors associated with this inappropriate use. A prospective consideration of these data could lead to the better use of this expensive form of nutritional support.