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Parenteral nutrition-related complications in older patients with acute intestinal failure: A descriptive cohort
Garrett Kang1, Mark Chang Chuen Cheah1, Poh Bee Yen2
1Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore.
Insights
Parenteral nutrition (PN) in older adults with acute intestinal failure showed similar complication rates and clinical outcomes compared to younger adults. This suggests PN is safe for elderly patients despite increased comorbidities.
Area of Science:
- Clinical Nutrition
- Gastroenterology
- Geriatric Medicine
Background:
- Parenteral nutrition (PN) is crucial for managing acute intestinal failure.
- Outcomes of PN in older adults with acute intestinal failure are not well-documented.
- This study addresses the gap in understanding PN-related complications in elderly patients.
Purpose of the Study:
- To compare parenteral nutrition-related complications in older versus younger adult patients with acute intestinal failure.
- To evaluate clinical outcomes associated with PN in these distinct age groups.
Main Methods:
- Retrospective descriptive study of inpatients receiving PN from January 2019 to December 2019.
- Patients were categorized into older (≥65 years) and younger (<65 years) adult groups.
- Comparison of demographic data, PN intake, length of stay, and PN-related complications.
Main Results:
- Older adults had higher comorbidity scores and lower functional status but received less energy, dextrose, and protein per kilogram.
- Mean length of stay was significantly shorter for older adults.
- No significant differences were observed in PN-related complications or clinical outcomes (infections, glucose abnormalities, mortality) between groups.
Conclusions:
- Parenteral nutrition in older adults with acute intestinal failure is associated with comparable complication rates and clinical outcomes to younger adults.
- Increased comorbidities in older adults did not translate to worse outcomes with PN therapy.
- PN can be safely administered to older adult patients with acute intestinal failure.
Introduction:
Reported outcomes for parenteral nutrition (PN)-related complications in older adult patients with acute intestinal failure who are receiving PN in the acute hospital setting are limited. Our study aims to compare PN-related complications between older and younger adult patients.
Methods:
A retrospective descriptive study of inpatients who were administered PN from January 1, 2019, to December 31, 2019, was performed. Patients were categorized into older (≥65 years old) and younger (<65 years old) adult groups.
Results:
Two hundred thirty-five patients were included. There were 103 patients in the older adult group (mean age: 73.9 [SD: 6.9] years) and 132 patients in the younger adult group (mean age: 52.4 [SD: 12.5] years). There was a significantly higher Charlson Comorbidity Index score and lower Karnofsky score in the older adult group. The older adult group received significantly lower total energy (20.8 [SD: 7.8] vs 22.8 [SD: 6.3] kcal/kg/day), dextrose (3.1 [SD: 1.4] vs 3.6 [SD: 1.4] g/kg/day), and protein (1.1 [SD: 0.4] vs 1.2 [SD: 0.3] g/kg/day) than the younger group received. The mean length of stay was significantly shorter in the older adult group (35.9 [SD: 21.3] vs 59.8 [SD: 55.3]; P < 0.05). There was no significant difference in PN-related complications and clinical outcomes (catheter-related bloodstream infections, hypoglycemia or hyperglycemia, fluid overload, or inpatient mortality) between the two groups.
Conclusion:
Despite more comorbidities in the older adult, the usage of PN in older adult patients with acute intestinal failure was associated with neither an increased rate of PN-related complications nor worse clinical outcomes when compared with that of younger patients.
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