Comparison of short-term mortality and morbidity between parenteral and enteral nutrition for adults without XXXX : a propensity-matched analysis using a national inpatient database.

@entity1 @entity295 @entity5 @entity55
BACKGROUND: Proper artificial nutrition for @entity1 who are unable to eat normally is an ongoing, unresolved concern in geriatric medicine and home medical care. Controversy surrounds prognostic differences between parenteral and enteral nutrition, 2 methods for artificial nutrition. OBJECTIVES: Short-term outcomes of parenteral and enteral nutrition for @entity1 who are unable to eat normally were compared and analyzed. DESIGN: Data were acquired from @entity1 selected from a national inpatient database covering 1057 hospitals in Japan. @entity1 had received artificial nutrition between April 2012 and March 2013, were aged >= 20 y, and did not have @entity5 . They were separated into 2 groups: those who received parenteral nutrition and those who received enteral nutrition. We performed one-to-one propensity score matching between the groups. The primary outcome measurements were mortality rates at 30 and 90 d after the start of the procedure. The secondary outcomes were postprocedural complications, @entity55 , and @entity295 . We analyzed survival length of stay after the procedure with the use of a Cox proportional hazards model. RESULTS: There were 3750 @entity1 in the parenteral group and 22,166 @entity1 in the enteral group. Propensity score matching created 2912 pairs in the 2 groups. @entity1 with a similar propensity score (probability of being assigned to the enteral group) calculated from the baseline condition were matched. Mortality rates at 30 and 90 d after start of treatment were 7.6% vs. 5.7% (P = 0.003) and 12.3% vs. 9.9% (P = 0.002) in the parenteral and enteral groups, respectively. In Cox regression analysis, the HR for the enteral group relative to the parenteral group was 0.62 (95% CI: 0.54, 0.71; P < 0.001). The incidences of @entity55 and @entity295 were 11.9% vs. 15.5% (P < 0.001) and 4.4% vs. 3.7% (P = 0.164) for the parenteral and enteral groups, respectively. CONCLUSION: The present analysis showed the better survival rate with enteral compared with parenteral nutrition for adults who were not suffering from @entity5 . This trial was registered at clinicaltrials.gov as NCT02512224.
