Commercial Enteral Formulas and Nutrition Support Teams Improve the Outcome of Home Enteral Tube Feeding

医学 肠外营养 肠内给药 优势比 置信区间 肺炎 观察研究 重症监护室 喂食管 急诊医学 儿科 重症监护医学 内科学 外科
作者
Stanisław Kłęk,P. Szybiński,Marek Sierżęga,Kinga Szczepanek,Magdalena Sumlet,M. Kupiec,Elzbieta Koczur‐Szozda,Malgorzata Steinhoff‐Nowak,K. Figula,Tomasz Kowalczyk,Jan Kulig
出处
期刊:Journal of Parenteral and Enteral Nutrition [Wiley]
卷期号:35 (3): 380-385 被引量:52
标识
DOI:10.1177/0148607110378860
摘要

Background: The benefits of home enteral tube feeding (HETF) provided by nutrition support teams (NSTs) have been questioned recently, given the growing costs to the healthcare system. This study examined the effect of a specialized home enteral nutrition program on clinical outcome variables in HETF patients. Methods: The observational study included 203 patients (103 women, 100 men; mean age 52.5 years) receiving HETF with homemade diets for at least 12 months before starting a specialized home nutrition program for another 12 months consisting of provision of commercial enteral formulas and the guidance of an NST. Both study periods were compared regarding the number of hospital admissions, length of hospital and intensive care unit (ICU) stay, and costs of hospitalization. Results: A specialized HETF program significantly reduced the number of hospital admissions and the duration of hospital and ICU stays. The need for hospitalization and ICU admission was significantly reduced, with odds ratios of 0.083 (95% confidence interval, 0.051–0.133, P < .001) and 0.259 (95% confidence interval, 0.124–0.539, P < .001), respectively. Specialized HETF was associated with a significant decrease in the prevalence of pneumonia (24.1% vs 14.2%), respiratory failure (7.3% vs 1.9%), urinary tract infection (11.3% vs 4.9%), and anemia (3.9% vs 0%) requiring hospitalization. The average yearly cost of hospital treatment decreased from $764.65 per patient to $142.66 per year per patient. Conclusions: The specialized HETF care program reduces morbidity and costs related to long‐term enteral feeding at home.

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