Protein intake tied to mortality in older patients receiving parenteral nutrition

Infused amino acid intake is positively associated with mortality in older patients receiving parenteral nutrition, a study has found.

A retrospective observational study was carried out using a national inpatient database covering >1,000 hospitals in Japan. The authors identified participants aged ≥65 years who underwent central venous (CV) port insertion between 2011 and 2016 and did not have cancer. They estimated the infused energy and amino acid intakes based on the types and amounts of products used for enteral and intravenous feeding on postoperative day (POD) 7 after CV port insertion.

Mortality on POD 90 was the primary endpoint. The associations of infused energy and amino acid intakes with mortality on POD 90 were assessed through multivariable logistic regression.

Overall, 10,153 patients who underwent CV port insertion participated in the study. Mortality rates at 90 days following CV port insertion were 14.9 percent and 14.0 percent (risk difference, 0.9 percent, 95 percent confidence interval [CI], 0.5–2.3 percent; p=0.216) with infused energy intakes <20 and ≥20 kcal/kg, respectively, and 15.4 percent and 13.2 percent (risk difference, 2.2 percent, 95 percent CI, 0.9–3.6 percent; p=0.001) with infused amino acid intakes <0.8 and ≥0.8 g/kg, respectively.

These differences persisted after adjusting for several variables, such as hospital, age, sex, body mass index, emergency admission, and 27 major underlying diseases.

Additionally, the odds ratio for the ≥0.8-g/kg group was 0.87 (95 percent CI, 0.77–0.99; p=0.028) compared with the <0.8-g/kg group.

“Malnutrition of inpatients is often overlooked and remains a serious concern,” the authors said. “However, there are few studies on the relations between infused energy and amino acid intakes and clinical outcomes in older patients on parenteral nutrition.”