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Clinical and biochemical characteristics of patients with home enteral nutrition in an area of Spain.
Eur J Clin Nutr. 2003 Apr; 57(4):612-5.EJ

Abstract

OBJECTIVE

The widespread use of long-term enteral nutrition and the substantive costs dictate a need to study outcome, clinical and epidemiological characteristics of these patients. The aim of our study was to analyze incidence, clinical and biochemical characteristics of a cohort of patients on home enteral nutrition (HEN).

DESIGN

Prospective observational study.

SETTING

Tertiary care.

SUBJECTS

Between January 1999 and December 2001, all adult patients living in Valladolid West area who were discharged from the hospital on HEN were prospectively studied and followed up.

INTERVENTIONS

Information for each patients was prospectively recorded by the dietitian of the team, and include age, sex, body mass index, tricipital skinfold, midarm circumference, underlying disease, exitus, dates of initiation and discontinuation of HEN, nutrient formula, mode of administration and complications of HEN. During HEN, physicians supervised the home patients and the patients themselves or their close relative were asked to contact our nutrition team if any problem occurred. Finally the yearly incidence of HEN was calculated each year on the basis of the estimated population in our area of recruitment, assuming almost all HEN patients were reported.

RESULTS

In 1999, the incidence of HEN in our area was patients 15 per 100000 inhabitants. This incidence rate rose to 21.3 in 2000 and decreased to 9.52 in 2001. The mean age of all patients was 58.7+/-13 y. The distribution of patients by diseases was: 71 (69.6%) had a head and neck cancer; 14 (13.7%) had a neurological disorder affecting swallowing (cerebrovacular accident and/or dementia); 6 (5.9%) had tumors in different locations with anorexia; and 11 (10.8%) had one of several miscellaneous diseases inducing dysphagia or anorexia. HEN was administered orally in 81 patients (79.4%), via a nasogastric tube (NGT) in 15 patients (14.7%), via a percutaneous gastrostomy (PEG) in five patients (4.9%), and via a jejunostomy in one patient (1%). The mean duration of HEN was 101+/-46.9 days. During the course of HEN, six patients had diarrhea (5.9%), and four (3.9%) constipation, and two vomiting (2%) that did not require cessation of HEN. Albumin, prealbumin, transferrin and lymphocytes improved in all the groups, when comparing the first review with the last. After the follow-up (3 y) with review, each 3 months, 10 of the 102 patients (9.8%) had died, and 92 (90.2%) were alive. Survival probability was influenced by the access route, with the worse outcome in patients with no oral nutrition (NGT, PEG and jejunostomy; hazard ratio: 24.9; 95% CI: 4.1-52), adjusted by age, sex and diagnosis.

CONCLUSIONS

In conclusion, HEN is a valid and safe technique for nutrition support, with a good clinical outcome in our area.

Authors+Show Affiliations

Seccione de Endocrinologia y Nutricion Clinica Hospital u Rio Hortega, Valladolid, Spain. dadluis@yahoo.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12700624

Citation

de Luis, D A., et al. "Clinical and Biochemical Characteristics of Patients With Home Enteral Nutrition in an Area of Spain." European Journal of Clinical Nutrition, vol. 57, no. 4, 2003, pp. 612-5.
de Luis DA, Aller R, de Luis J, et al. Clinical and biochemical characteristics of patients with home enteral nutrition in an area of Spain. Eur J Clin Nutr. 2003;57(4):612-5.
de Luis, D. A., Aller, R., de Luis, J., Izaola, O., Romero, E., Terroba, M. C., & Cuellar, L. A. (2003). Clinical and biochemical characteristics of patients with home enteral nutrition in an area of Spain. European Journal of Clinical Nutrition, 57(4), 612-5.
de Luis DA, et al. Clinical and Biochemical Characteristics of Patients With Home Enteral Nutrition in an Area of Spain. Eur J Clin Nutr. 2003;57(4):612-5. PubMed PMID: 12700624.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and biochemical characteristics of patients with home enteral nutrition in an area of Spain. AU - de Luis,D A, AU - Aller,R, AU - de Luis,J, AU - Izaola,O, AU - Romero,E, AU - Terroba,M C, AU - Cuellar,L A, PY - 2002/01/18/received PY - 2002/03/27/revised PY - 2002/06/17/accepted PY - 2003/4/18/pubmed PY - 2003/8/2/medline PY - 2003/4/18/entrez SP - 612 EP - 5 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 57 IS - 4 N2 - OBJECTIVE: The widespread use of long-term enteral nutrition and the substantive costs dictate a need to study outcome, clinical and epidemiological characteristics of these patients. The aim of our study was to analyze incidence, clinical and biochemical characteristics of a cohort of patients on home enteral nutrition (HEN). DESIGN: Prospective observational study. SETTING: Tertiary care. SUBJECTS: Between January 1999 and December 2001, all adult patients living in Valladolid West area who were discharged from the hospital on HEN were prospectively studied and followed up. INTERVENTIONS: Information for each patients was prospectively recorded by the dietitian of the team, and include age, sex, body mass index, tricipital skinfold, midarm circumference, underlying disease, exitus, dates of initiation and discontinuation of HEN, nutrient formula, mode of administration and complications of HEN. During HEN, physicians supervised the home patients and the patients themselves or their close relative were asked to contact our nutrition team if any problem occurred. Finally the yearly incidence of HEN was calculated each year on the basis of the estimated population in our area of recruitment, assuming almost all HEN patients were reported. RESULTS: In 1999, the incidence of HEN in our area was patients 15 per 100000 inhabitants. This incidence rate rose to 21.3 in 2000 and decreased to 9.52 in 2001. The mean age of all patients was 58.7+/-13 y. The distribution of patients by diseases was: 71 (69.6%) had a head and neck cancer; 14 (13.7%) had a neurological disorder affecting swallowing (cerebrovacular accident and/or dementia); 6 (5.9%) had tumors in different locations with anorexia; and 11 (10.8%) had one of several miscellaneous diseases inducing dysphagia or anorexia. HEN was administered orally in 81 patients (79.4%), via a nasogastric tube (NGT) in 15 patients (14.7%), via a percutaneous gastrostomy (PEG) in five patients (4.9%), and via a jejunostomy in one patient (1%). The mean duration of HEN was 101+/-46.9 days. During the course of HEN, six patients had diarrhea (5.9%), and four (3.9%) constipation, and two vomiting (2%) that did not require cessation of HEN. Albumin, prealbumin, transferrin and lymphocytes improved in all the groups, when comparing the first review with the last. After the follow-up (3 y) with review, each 3 months, 10 of the 102 patients (9.8%) had died, and 92 (90.2%) were alive. Survival probability was influenced by the access route, with the worse outcome in patients with no oral nutrition (NGT, PEG and jejunostomy; hazard ratio: 24.9; 95% CI: 4.1-52), adjusted by age, sex and diagnosis. CONCLUSIONS: In conclusion, HEN is a valid and safe technique for nutrition support, with a good clinical outcome in our area. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/12700624/Clinical_and_biochemical_characteristics_of_patients_with_home_enteral_nutrition_in_an_area_of_Spain_ L2 - https://doi.org/10.1038/sj.ejcn.1601580 DB - PRIME DP - Unbound Medicine ER -