ArticleCancers2024
Safety and Efficacy of Initiating Parenteral Nutrition at Home, Home Start PN, in Advanced Peritoneal Metastasis.
Article in Cancers, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
backgroundPatients with peritoneal carcinomatosis often experience intestinal failure throughout the course of their disease, and total parenteral nutrition (TPN) can be used as a temporary solution or as a bridge to definitive cytoreductive surgery. Guidelines for TPN are well established for inpatients and in 2014, guidelines were established for the initiation of TPN for outpatients in a home setting. However, the safety and efficacy of home start TPN in advanced oncology patients remain unknown. This study aims to explore the safety and efficacy of starting TPN in the home setting for patients with peritoneal carcinomatosis.
methodHealth records of advanced cancer patients receiving TPN during 2009-2020 were retrospectively reviewed. Data pertaining to diagnosis, demographics, nutritional parameters, and outcomes including hospital readmission rates were collected. Safety was measured based on catheter-related complications and hospital admissions related to electrolyte or fluid imbalance due to TPN. Efficacy was determined by weight gain/stability and pre-albumin and albumin levels. The Fisher's exact and Kruskal-Wallis tests were used to analyze the data.
resultsSeventy TPN patients were identified, of which forty-two were home start (HS) and twenty-eight were in hospital (HP). The two groups were not significantly different in age, (HS: mean = 58.3 ± 13.9; HP: mean = 58.0 ± 13;
conclusionsThis is the first study to present a comparison between home and hospital start TPN in advanced cancer patients, demonstrating that the initiation of outpatient TPN in the home setting is as safe and efficacious as TPN initiated in the hospital.
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