Peripheral Parenteral Nutrition and Activities of Daily Living in Hospitalized Older Frail Patients.

Autor:	Soma S; Emergency and Critical Care Center, Aomori Prefectural Central Hospital, Aomori, JPN., Tazawa Y; Nutrition Management, Aomori Prefectural Central Hospital, Aomori, JPN., Yamada S; Rehabilitation, Aomori Prefectural Central Hospital, Aomori, JPN., Szuki N; Rehabilitation, Aomori Prefectural Central Hospital, Aomori, JPN., Narita D; Rehabilitation, Aomori Prefectural Central Hospital, Aomori, JPN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Aug 31; Vol. 15 (8), pp. e44423. Date of Electronic Publication: 2023 Aug 31 (Print Publication: 2023).
DOI:	10.7759/cureus.44423
Abstrakt:	Background: Frail older adults require nursing care following hospitalization for acute illnesses. Frailty is reversible, and appropriate nutritional management and rehabilitation during hospitalization are essential. However, optimal nutritional management for patients who are unable to obtain adequate nutrition via oral intake has not been established. We aimed to determine whether peripheral parenteral nutrition (PPN) promotes the recovery of activities of daily living (ADLs) in frail older patients. Methods: This was a retrospective, observational cohort study conducted at the General Medicine Department of Aomori Prefectural Central Hospital in Aomori, Japan. The primary outcome was recovery of the Barthel index (BI) from the beginning of rehabilitation to discharge, and the secondary outcomes were the proportion of patients transferred for rehabilitation and the nutritional status. Results: In total, 342 patients hospitalized during the period of April 2018 to January 2022 were included, of whom 127 (37.1%) received PPN and 215 (62.9%) did not. Contrary to our expectations, recovery of the BI was lower in the PPN group than that in the non-PPN group (12.2 (95% confidence interval (CI): 8.5-16.0) vs. 22.4 (18.8-23.0); p < 0.01). Multivariable analysis revealed PPN as an independent risk factor for poor BI recovery (mean difference = -7.3 (95% CI = -12.7 to -1.9)). Conclusion: Nutritional management through PPN for frail older adults may not improve physical activity. The nutritional management of frail patients with inadequate oral intake remains challenging. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Soma et al.)
Databáze:	MEDLINE
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