Evaluation of the total parenteral nutrition service at Universiti Sains Malaysia Hospital

Abstract

Summary Background & aims: Total parenteral nutrition (TPN) has been practised in Universiti Sains Malaysia Hospital (HUSM), Malaysia, since 1986. Unfortunately, there are no published data on the cost, complications and outcomes of patients treated with TPN in HUSM. This study was carried out to evaluate the cost, complications and outcomes of TPN. Methods: Retrospective data were obtained from patient medical records, and 215 TPN cases from 2003 to 2005 were evaluated. The data were analyzed using SPSS version 11. Results: The demographics of the TPN cases were neonates 22.8%, pediatric 11%, adults 64.6%, males 52.6%, females 46.1%. Malays comprise 87.4%, Chinese 6.0% and Indians 1.9%. The average cost for TPN in neonates is RM 98746, pediatric RM 2107121 and adult RM 3987103. TPN-associated complications were electrolyte complications (56.5%), acid– base imbalance (5.5%), renal complications (14.5%), liver complications (12.4%), hyperglycemia (9%), hyperlipidemia (0.7%) and hypoglycemia (0.7%). The outcomes were that 71.2% cases tolerated oral nutrition and 1.8% expired. The study showed a significant difference in the cost of TPN in each group of patients (P ¼ 0.000). Conclusion: The cost and outcomes of TPN services in HUSM were similar to other centers, however, it was associated with relatively high TPN-related complications. & 2007 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.