Nutritional Support Team, National Medical Center for Global Health and Medicine, Tokyo, Japan.
Nutrition. 2011 Nov-Dec;27(11-12):1112-7. doi: 10.1016/j.nut.2010.11.010. Epub 2011 Apr 9.
The objective of the present study was to evaluate the economic and clinical efficacy of a multidisciplinary nutritional support team (NST) for autologous stem cell transplantation.
We performed a retrospective cost-benefit analysis of autologous stem cell transplantation (ASCT) in patients with and without NST intervention at a single institute. Patients (n = 120) had undergone 169 ASCTs, 67 before the commencement of NST intervention in September 2005 and 102 after September 2005. The conditioning regimens, prophylactic antibiotics, and supportive care were unchanged from 2001 through 2008. The duration of hospitalization, cost, and laboratory data were analyzed.
With NST intervention, the duration of total parenteral nutrition, absence of oral food intake, hospitalization, and therapeutic antibiotic usage were significantly shortened by 11.4, 9.7, 8.1, and 4.5 d, respectively. With NST intervention, the incidence of hepatic adverse events and hyperglycemia was low, and the total cost of hospitalization was significantly decreased by 403 600 yen (US $4484.40). Two cases of therapy-related death were recorded before September 2005. No therapy-related mortality was observed after commencement of NST intervention; however, the difference was not significant.
Multidisciplinary NST intervention has a positive effect on cost decrease, and it may decrease the incidence of adverse events associated with ASCT and total parenteral nutrition.
本研究旨在评估多学科营养支持小组（NST）对自体干细胞移植的经济和临床疗效。
我们对单家医院接受和未接受 NST 干预的自体干细胞移植（ASCT）患者进行了回顾性成本效益分析。患者（n=120）共进行了 169 次 ASCT，其中 67 次在 2005 年 9 月开始 NST 干预之前，102 次在 2005 年 9 月之后。从 2001 年到 2008 年，预处理方案、预防性抗生素和支持性护理均未改变。分析了住院时间、成本和实验室数据。
接受 NST 干预后，全肠外营养、无口服摄入、住院和治疗性抗生素使用的时间分别显著缩短了 11.4、9.7、8.1 和 4.5 天。接受 NST 干预后，肝不良事件和高血糖的发生率较低，住院总费用显著降低了 403600 日元（4484.40 美元）。2005 年 9 月之前有 2 例治疗相关死亡。NST 干预开始后未观察到与治疗相关的死亡，但差异无统计学意义。
多学科 NST 干预对降低成本有积极影响，可能降低与 ASCT 和全肠外营养相关的不良事件发生率。
