MCACS - Total Parenteral Nutrition Infusion During Septicemia is Associated with Longer Hospitalization

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Total Parenteral Nutrition Infusion During Septicemia is Associated with Longer Hospitalization
Vihas Patel, MD¹, Guotong Man, MD, PhD¹, Caryn Domenici Belisle, RPh², Stanley Ashley, MD¹
¹Department of Surgery and ²Department of Pharmacy, Brigham and Women's Hospital, Boston, MA

Background: Total parenteral nutrition (TPN) has enhanced nutrition delivery to enterally intolerant patients but it can be complicated by bloodstream infection (CRBSI). There are no evidence-based recommendations regarding TPN infusion during septicemia. A 2009 practice survey we conducted via the American Society for Parenteral and Enteral Nutrition listserv revealed no consensus among nutritionists, with 71% stating they would continue TPN during septicemia.
Methods: All adult patients who received TPN and who developed septicemia at Brigham and Women's Hospital during 2007 were retrospectively analyzed. Patients were grouped into TPN-continued versus TPN-stopped within 48hrs of septicemia. Appropriate statistical analyses were conducted using SPSS Inc.
Results: Of 45131 admissions, 1% (N=476) received TPN and 67 developed septicemia. Patients who continued to receive TPN after septicemia were more likely to have longer hospitalization, which remained statistically significant after adjusting for known covariates (Odds Ratio 11.2). See tables 1-3 and graph for details.
Conclusion: Our analysis showed patients who continued to receive TPN after septicemia had no difference in mortality or septicemia recurrence but had significantly longer duration of hospitalization.

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