Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
Department of Medicine and Aging, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
Clin Ter. 2022 Apr 4;173(2):115-120. doi: 10.7417/CT.2022.2404.
Recent trials and reviews have raised question about the safety of total parenteral nutrition (TPN), due to the increased rate of TPN related complications. Diabetic patients are vulnerable to hyperglycaemia, and poor studies have investigated hospital out-comes of diabetic patients requiring TPN. The aim of this study was to evaluate the association of in-hospital mortality, prolonged length of stay and transfer to long-term care facilities among diabetic patients with TPN.
The study considered all hospital admissions of diabetic patients over 65 years of age performed between 2006 and 2015 in Abruzzo Region, Italy. To compare the outcomes of TPN and non-TPN patients, a propensity score matching procedure was performed.
A total of 140,556 admissions were analyzed. After matching, 1947 patients were included into the analyses: 649 patients with TPN and 1298 controls. TPN was significantly associated to in-hospital mortality (OR=7.15; 95%CI 5.54-9.22), prolonged LOS (OR=2.78; 95%CI 2.28-3.38) and transfer to LTCF (OR=2.16; 95%CI 1.64-2.85).
TPN is associated with poor outcomes among elderly diabetic patients in the Italian setting. Being aware of the risk factors among diabetic patients with TPN can be used to anticipate the patients' needs during the admission and the immediate post-discharge period.
最近的试验和综述对全肠外营养（TPN）的安全性提出了质疑，因为 TPN 相关并发症的发生率有所增加。糖尿病患者易发生高血糖，而研究不佳的研究调查了需要 TPN 的糖尿病患者的住院结局。本研究旨在评估糖尿病患者 TPN 与住院死亡率、住院时间延长和转入长期护理机构之间的关联。
本研究考虑了 2006 年至 2015 年期间意大利阿布鲁佐地区 65 岁以上的所有住院糖尿病患者。为了比较 TPN 和非 TPN 患者的结局，进行了倾向评分匹配程序。
共分析了 140556 例住院患者。匹配后，共有 1947 例患者纳入分析：649 例 TPN 患者和 1298 例对照。TPN 与住院死亡率（OR=7.15；95%CI 5.54-9.22）、延长 LOS（OR=2.78；95%CI 2.28-3.38）和转入 LTCF（OR=2.16；95%CI 1.64-2.85）显著相关。
在意大利环境中，TPN 与老年糖尿病患者的不良结局相关。了解 TPN 糖尿病患者的风险因素可用于预测患者在住院期间和出院后的需求。
