经鼻胃管喂养与全肠外营养在老年肺炎伴吞咽困难患者中的应用：回顾性队列研究。

Nasogastric Tube Feeding Versus Total Parenteral Nutrition in Older Dysphagic Patients with Pneumonia: Retrospective Cohort Study.

机构信息

Ryo Momosaki, MD, PhD, MPH, Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan, Tel: +81 59 232 1111; Fax: +81 59 231 5661, E-mail:

出版信息

J Nutr Health Aging. 2020;24(8):883-887. doi: 10.1007/s12603-020-1414-4.

DOI:10.1007/s12603-020-1414-4

PMID:33009540

Abstract

OBJECTIVES

Many older patients with pneumonia cannot intake orally after admission and may need nutritional care such as nasogastric tube feeding or total parenteral nutrition. This study sought to compare in-hospital outcomes between patients receiving nasogastric tube feeding and total parenteral nutrition.

DESIGN

This is a retrospective cohort study.

SETTING

A hospital-based database constructed by the Diagnosis Procedure Combination survey data comprising more than 100 acute-care hospitals.

PARTICIPANTS

The study included consecutive older inpatients aged >65 years admitted to participating hospitals with a diagnosis of pneumonia from 2014 through 2017.

MEASUREMENTS

We compared patients who received total parenteral nutrition and those who received nasogastric tube feeding in terms of characteristics and outcomes.

RESULTS

Among the included inpatients, a total of 336 (73.2%) patients received total parenteral nutrition and 123 (26.8%) patients received nasogastric tube feeding. Patients with nasogastric tube feeding had less in-hospital mortality (13.8% vs 27.1%, p = 0.003) and a smaller number of complications (mean; 0.71 vs 1.44, p <0.001), shorter length of hospital stay (mean; 27.6 vs 48.9, p <0.001), more discharges home (72.4% vs 35.1%, p <0.001), and more discharges without oral intake (65.9% vs 45.8%, p <0.001) than patients with total parenteral nutrition. The same results were obtained in propensity score analysis.

CONCLUSIONS

Older patients with pneumonia treated with total parenteral nutrition were significantly more likely to have higher in-hospital mortality than those receiving nasogastric tube feeding.

摘要

目的

许多患有肺炎的老年患者入院后无法口服，可能需要鼻饲管喂养或全胃肠外营养等营养支持。本研究旨在比较接受鼻饲管喂养和全胃肠外营养的患者的住院期间结局。

设计

这是一项回顾性队列研究。

设置

由诊断程序组合调查数据构建的基于医院的数据库，该数据库包含 100 多家急性护理医院。

参与者

该研究纳入了 2014 年至 2017 年期间在参与医院住院、诊断为肺炎且年龄>65 岁的连续老年住院患者。

测量方法

我们比较了接受全胃肠外营养和鼻饲管喂养的患者在特征和结局方面的差异。

结果

在纳入的住院患者中，共有 336 例（73.2%）患者接受全胃肠外营养，123 例（26.8%）患者接受鼻饲管喂养。与接受全胃肠外营养的患者相比，接受鼻饲管喂养的患者住院期间死亡率更低（13.8% vs. 27.1%，p=0.003），并发症更少（平均值；0.71 vs. 1.44，p<0.001），住院时间更短（平均值；27.6 vs. 48.9，p<0.001），更多出院回家（72.4% vs. 35.1%，p<0.001），更多出院时无需口服摄入（65.9% vs. 45.8%，p<0.001）。倾向评分分析也得到了相同的结果。