Association between parenteral nutrition in the early phase and outcomes in patients with abdominal trauma undergoing emergency laparotomy: A retrospective nationwide study. (February 2021)

• Record Type: Journal Article
• Authors: Otaka, Shunichi; Aso, Shotaro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo
• Is Part Of: Clinical nutrition ESPEN. Volume 41(2021)
• Page Start: 371
• Page End: 376
• Publication Date: 2021-02
• Subjects: Parenteral nutrition -- Abdominal trauma -- Abdominal surgery -- Overlap weights; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2020.10.018
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Background & aims: Parenteral nutrition in the early phase is often performed for patients with trauma who have undergone laparotomy. However, the clinical benefits of parenteral nutrition in the early phase in this population remain unknown. We investigated the association of parenteral nutrition in the early phase with outcomes in patients with trauma who underwent emergency laparotomy. Methods: Using a Japanese nationwide database from July 2010 to March 2018, we identified patients with trauma who underwent emergency laparotomy on admission to the hospital, required mechanical ventilation on admission, and did not receive enteral nutrition within 2 days after admission. We performed an overlap weights analysis to compare in-hospital outcomes between patients with and without parenteral nutrition in the early phase. The primary outcome was the duration of mechanical ventilation. The secondary outcomes were the length of hospital stay, total hospitalization cost, tracheostomy, hospital-acquired pneumonia, and all-cause 28-day in-hospital mortality. Results: In total, 1700 adult patients were included. There were no significant associations between parenteral nutrition in the early phase and the duration of mechanical ventilation (difference, −0.4 days; 95% confidence interval, −2.9 to 2.2), length of hospital stay (difference, 1.3 days; 95% confidence interval, −5.0 to 7.5), total hospitalization cost (difference, US$ 730; 95% confidence interval, −2911 to 4370), tracheostomy (risk difference, 0.01; 95% confidence interval, −0.03 to 0.05), hospital-acquired pneumonia (risk difference, −0.01; 95% confidence interval, −0.05 to 0.03), or all-cause 28-day in-hospital mortality (risk difference, 0.02; 95% confidence interval, −0.01 to 0.06). Conclusions: Parenteral nutrition in the early phase for patients with trauma undergoing emergency laparotomy was not associated with better in-hospital outcomes.