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KMID : 1034120190110010012
Journal of Clinical Nutrition
2019 Volume.11 No. 1 p.12 ~ p.22
Nutritional Therapy Related Complications in Hospitalized Adult Patients: A Korean Multicenter Trial
Seol Eun-Mi

Kwon Kye-Sook
Kim Jung-Koo
Kim Jung-Tae
Kim Ji-Hoon
Moon Sun-Mi
Park Do-Joong
Park Jung-Hyun
Park Je-Hoon
Park Ji-Young
Bae Jung-Min
Ryu Seung-Wan
Sul Ji-Young
Shin Dong-Woo
Shin Cheung-Soo
Ahn Byung-Kyu
Ahn Su-Min
Yu Hee-Chul
Lee Gil-Jae
Lee Sang-Hoon
Lee A-Ran
Jang Jae-Young
Jeon Hwang-Gyun
Jung Sung-Min
Han Sung-Sik
Hong Soo-Jung
Hwang Soo-Jeong
Choi Yun-Hee
Lee Hyuk-Joon
Abstract
Purpose: Nutritional therapy (NT), such as enteral nutrition (EN) or parenteral nutrition (PN), is essential for the malnourished patients. Although the complications related to NT has been well described, multicenter data on symptoms in the patients with receiving NT during hospitalization are still lacking.

Methods: Nutrition support team (NST) consultations, on which NT-related complications were described, were collected retrospectively for one year. The inclusion criteria were patients who were (1) older than 18 years, (2) hospitalized, and (3) receiving EN or PN at the time of NST consultation. The patients¡¯ demographics (age, sex, body mass index [BMI]), type of NT and type of complication were collected. To compare the severity of each complication, the intensive care unit (ICU) admission, hospital stay, and type of discharge were also collected.

Results: A total of 14,600 NT-related complications were collected from 13,418 cases from 27 hospitals in Korea. The mean age and BMI were 65.4 years and 21.8 kg/m2. The complications according to the type of NT, calorie deficiency (32.4%, n=1,229) and diarrhea (21.6%, n=820) were most common in EN. Similarly, calorie deficiency (56.8%, n=4,030) and GI problem except for diarrhea (8.6%, n=611) were most common in PN. Regarding the clinical outcomes, 18.7% (n=2,158) finally expired, 58.1% (n=7,027) were admitted to ICU, and the mean hospital days after NT-related complication were 31.3 days. Volume overload (odds ratio [OR]=3.48) and renal abnormality (OR=2.50) were closely associated with hospital death; hyperammonemia (OR=3.09) and renal abnormality (OR=2.77) were associated with ICU admission; ¡°micronutrient and vitamin deficiency¡± (geometric mean [GM]=2.23) and volume overload (GM=1.61) were associated with a longer hospital stay.

Conclusion: NT may induce or be associated with several complications, and some of them may seriously affect the patient¡¯s outcome. NST personnel in each hospital should be aware of each problem during nutritional support.
KEYWORD
Nutrition therapy, Parenteral nutrition, Enteral nutrition, Complications, Multicenter study
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