Abstract
Aim: Elderly patients hospitalized in the internal medicine department who do not have sufficient oral nutritional intake and fall into low nutrition require artificial hydration and nutrition. Here, the effectiveness of total parenteral nutrition (TPN) was compared to the nutritional administration methods for discharged patients. Methods: 508 elderly inpatients who were admitted to the internal medicine department of an emergency hospital and administered TPN over 9 years were divided into two groups: patients who were discharged (331) and those who died in the hospital (177). Patients were further divided into four groups at the time of discharge from the hospital: oral nutrition, enteral nutrition, peripheral parenteral nutrition and TPN. The effectiveness of TPN was evaluated using serum albumin level and the COntrolling NUTrition Status Score (CONUT) nutritional evaluation tool. Results: While the nutritional status of patients of oral and enteral nutrition improved upon discharge, the CONUT of TPN patients without oral or enteral nutrition did not improve and serum albumin levels of the patients deteriorated. Conclusion: To discharge patients alive and safe, efforts must be made to continue oral and enteral nutrition for as long as possible.
Highlights
Introduction and PurposeJapan currently has a multi-death super-aging society
Patients who have difficulty taking food and water orally have a low rate of 10 - 20% prospect of improving swallowing function [1]
The living discharge group consisted of 331 patients (65.2%; mean age, 85.8±6.9 years), of which 144 were males and 187 were females
Summary
Japan currently has a multi-death super-aging society. Patients who have difficulty taking food and water orally have a low rate of 10 - 20% prospect of improving swallowing function [1]. The ideal nutritional administration method is oral nutrition (ON) > enteral nutrition (EN) > parenteral nutrition (PN) [2], and patients who have insufficient oral nutritional intake and fall into low nutrition need artificial hydration and nutrition (AHN). AHN includes EN, peripheral PN, and total parenteral nutrition (TPN). EN uses intestinal ducts with percutaneous endoscopic gastrotomy (PEG) or inserts nasogastric (NG) tube into the stomach or duodenum. PPN refers to the intravenous infusion from the peripheral veins of limbs
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