1. Changes in Home Parenteral Nutrition Practice Based on the Canadian Home Parenteral Nutrition Patient Registry.
- Author
-
Hortencio, Taís Daiene Russo, Arendt, Bianca Maria, Teterina, Anastasia, Jeejeebhoy, Khursheed N., Gramlich, Leah M., Whittaker, J. Scott, Armstrong, David, Raman, Maitreyi, Nogueira, Roberto José Negrão, and Allard, Johane P.
- Subjects
SEPTICEMIA treatment ,SHORT bowel syndrome ,CENTRAL venous catheters ,CATHETER-related infections ,HOME care services ,HOSPITAL care ,INTRAVENOUS catheterization ,NUTRITION ,NUTRITIONAL assessment ,ACQUISITION of data ,RETROSPECTIVE studies ,STANDARDS ,THERAPEUTICS ,INFECTION prevention - Abstract
Background: Since 2005, the Canadian home parenteral nutrition (HPN) registry has collected data on patients' demography, outcomes, and HPN clinical practice. At annual meetings, Canadian HPN programs review and discuss results.Aim: To evaluate changes over time in patient demography, outcomes, and HPN clinical practice using the registry data.Methods: This retrospective study evaluated 369 patients who were prospectively entered in the registry. Two periods were compared for the first data entry: 2005-2008 (n = 182) and 2011-2014 (n = 187). Patient demography, indications for HPN, HPN regimen, nutrition assessment, vascular access, and number of line sepsis per 1000 catheter days were evaluated.Results: For 2011-2014 compared with 2005-2008, indications for HPN changed significantly, with an increased proportion of patients with cancer (37.9% vs 16.7%) and with fewer cases of short bowel syndrome (32% vs 65.5%); line sepsis rate decreased from 1.58 to 0.97 per 1000 catheter days; and the use of tunneled catheters decreased from 64.3% to 38.0% and was no longer the most frequently chosen vascular access method. In contrast, the proportion of peripherally inserted central catheters increased from 21.6% to 52.9%. In addition, there was a reduction in number and days of hospitalizations related to HPN, and favorable changes were noted in the prescription of energy, proteins, and trace elements.Conclusion: The Canadian HPN registry is useful in tracking trends in demography, outcomes, and clinical practice. Results suggest a shift in patient demography and line access with improvement in line sepsis, hospitalizations, and HPN prescriptions. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF