Total parenteral nutrition is associated with worse hospital outcomes among elderly diabetic patients: a propensity score matched analysis on discharge records
V. 173 N. 2 (2022), Research article
V. 173 N. 2 (2022)

Total parenteral nutrition is associated with worse hospital outcomes among elderly diabetic patients: a propensity score matched analysis on discharge records: doi: 10.7417/CT.2022.2404

Research article
Pubblicato 2022-04-07
P. Di Giovanni
Department of Pharmacy, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
G. Di Martino
Department of Medicine and Aging, “G.d’Annunzio” University of Chieti-Pescara, Chieti, Italy
F. Cedrone
School of Public Health and Preventive Medicine, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
F. Meo
School of Public Health and Preventive Medicine, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
P. Scampoli
School of Public Health and Preventive Medicine, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
F. Romano
Department of Public Health and Infectious Diseases, “La Sapienza” University of Rome,Rome, Italy
T. Staniscia
Department of Medicine and Aging, “G.d’Annunzio” University of Chieti-Pescara, Chieti, Italy
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Parole chiave

diabetes
parenteral nutrition
outcomes
HDR
epidemiology

Abstract

Background

Recent trials and reviews have raised question about the safety of total parenteral nutrition (TPN), due to the increased rate of TPN related complications. Diabetic patients are vulnerable to hyperglycaemia, and poor studies have investigated hospital outcomes of diabetic patients requiring TPN. The aim of this study was to evaluate the association of in-hospital mortality, prolonged length of stay and transfer to long-term care facilities among diabetic patients with TPN.

Methods

The study considered all hospital admissions of diabetic patients over 65 years of age performed between 2006 and 2015 in Abruzzo Region, Italy. To compare the outcomes of TPN and non-TPN patients, a propensity score matching procedure was performed.

Results

A total of 140,556 admissions were analyzed. After matching, 1947 patients were included into the analyses: 649 patients with TPN and 1298 controls. TPN was significantly associated to in-hospital mortality (OR=7.15; 95%CI 5.54-9.22), prolonged LOS (OR=2.78; 95%CI 2.28-3.38) and transfer to LTCF (OR=2.16; 95%CI 1.64-2.85).

Conclusions

TPN is associated with poor outcomes among elderly diabetic patients in the Italian setting. Being aware of the risk factors among diabetic patients with TPN can be used to anticipate the patients’ needs during the admission and the immediate post-discharge period.

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