Parenteral nutrition and hospital outcomes in Australian adults: A descriptive cohort study

There is limited information regarding real-world use of parenteral nutrition in hospitals. The objective of the study was to provide a real-world description of parenteral nutrition administration in hospitalized patients.

This was a descriptive cohort study in 507 hospitalized adults who received parenteral nutrition at five Australian hospitals from 2015 to 2020. Adult patients (≥18 years) receiving parenteral nutrition in the hospital were eligible. Data collected included baseline demographics, comorbidities, clinician-determined indication and administration details for parenteral nutrition. The primary outcome was the indication for parenteral nutrition. Secondary outcomes included the use of supplemental parenteral nutrition and the vascular access devices used.

Of the 507 enrolled patients, 263 (52%) were in the intensive care unit and 244 (48%) in the ward at the time of enrolment. The most common indication for parenteral nutrition was a non-functioning gastrointestinal tract (45% [390/864 indications]), mostly because of ileus (18% [71/390]), followed by inadequate nutrition (35% [304/864]). More than half the patients (347/507, 68%) had a nil by mouth order by their treating team. The median duration of parenteral nutrition administration was 7 (4;14) days. Supplemental parenteral nutrition was more common for patients in the intensive care unit. Vascular access was most achieved via central venous catheter in intensive care unit patients (81%) compared to a peripherally inserted central catheter line in ward patients (75%).

This study provides novel real-world data on the demographics, indications, provision and outcomes of parenteral nutrition for hospitalized patients. Commonly reported indications for parenteral nutrition were ileus and nil by mouth orders, which may warrant further study.