Home parenteral nutrition registry: A five-year retrospective evaluation of outcomes of patients receiving home parenteral nutrition support

Abstract

Objective Few data are currently reported on home parenteral nutrition (HPN) patient outcomes, which makes evaluating comparative outcomes in HPN difficult. This study describes outcomes of consecutive HPN patients collected retrospectively over a 5-y period by one HPN support provider. Methods Retrospective data from the HPN support provider was aggregated yearly from 1997 to 2001. Length of therapy, demographics, diagnosis, rehospitalizations, catheter infection rate, catheter occlusion rate, and mechanical complication rate data were reported. Results The mean age of HPN patients ranged from 42 y to 45 y. The average length of HPN therapy was 100 d. There were more female than male HPN patients. Nutritional deficiency and malabsorption were the most common International Classification of Diseases, Ninth Revision codes for HPN use and reflects a focus on nutritional diagnosis rather than on disease state as the criterion for HPN use. Catheter infection rates ranged from 0.44 to 0.84 per 1000 catheter days, a lower than anticipated number. Mean catheter occlusion rates were lower than 7% and mean mechanical complication rates were approximately 5%. Known termination of therapy was secondary to completion of therapy (50% to 56%) or death (17.3% to 22%). Conclusions Overall, time on HPN therapy in the United States has increased. Nutritional diagnoses are currently used to justify HPN. Catheter infection and occlusion rates, in general, are low. Termination of therapy and death are the most common reasons for HPN discontinuation. Standardization of HPN data collection is necessary to obtain a historical snapshot of the efficacy and safety of patients treated outside the hospital with nutritional support.