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Nutritional Therapy Related Complications in Hospitalized Adult Patients: A Korean Multicenter Trial
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Eun-Mi Seol, Kye Sook Kwon, Jeong Goo Kim, Jung-Tae Kim, Jihoon Kim, Sun-Mi Moon, Do Joong Park, Jung Hyun Park, Je Hoon Park, Ji Young Park, Jung-Min Bae, Seung Wan Ryu, Ji-Young Sul, Dong Woo Shin, Cheung Soo Shin, Byung Kyu Ahn, Soo Min Ahn, Hee Chul Yu, Gil Jae Lee, Sanghoon Lee, A Ran Lee, Jae Young Jang, Hyun Jeong Jeon, Sung Min Jung, Sung-Sik Han, Suk-Kyung Hong, Sun-Hwi Hwang, Yunhee Choi, Hyuk-Joon Lee
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J Clin Nutr 2019;11(1):12-22. Published online June 30, 2019
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DOI: https://doi.org/10.15747/jcn.2019.11.1.12
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 Abstract
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Purpose:Nutritional therapy (NT), such as enteral nutrition (EN) or parenteral nutrition (PN), is essential for the malnourished patients. Although the complications related to NT has been well described, multicenter data on symptoms in the patients with receiving NT during hospitalization are still lacking. Methods:Nutrition support team (NST) consultations, on which NT-related complications were described, were collected retrospectively for one year. The inclusion criteria were patients who were (1) older than 18 years, (2) hospitalized, and (3) receiving EN or PN at the time of NST consultation. The patients’ demographics (age, sex, body mass index [BMI]), type of NT and type of complication were collected. To compare the severity of each complication, the intensive care unit (ICU) admission, hospital stay, and type of discharge were also collected. Results:A total of 14,600 NT-related complications were collected from 13,418 cases from 27 hospitals in Korea. The mean age and BMI were 65.4 years and 21.8 kg/m2. The complications according to the type of NT, calorie deficiency (32.4%, n=1,229) and diarrhea (21.6%, n=820) were most common in EN. Similarly, calorie deficiency (56.8%, n=4,030) and GI problem except for diarrhea (8.6%, n=611) were most common in PN. Regarding the clinical outcomes, 18.7% (n=2,158) finally expired, 58.1% (n=7,027) were admitted to ICU, and the mean hospital days after NT-related complication were 31.3 days. Volume overload (odds ratio [OR]=3.48) and renal abnormality (OR=2.50) were closely associated with hospital death; hyperammonemia (OR=3.09) and renal abnormality (OR=2.77) were associated with ICU admission; “micronutrient and vitamin deficiency” (geometric mean [GM]=2.23) and volume overload (GM=1.61) were associated with a longer hospital stay. Conclusion:NT may induce or be associated with several complications, and some of them may seriously affect the patient’s outcome. NST personnel in each hospital should be aware of each problem during nutritional support.
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The Present and Future of Nutrition Support Team
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Ji-Young Sul, Jeong Goo Kim
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Surg Metab Nutr 2019;10(1):1-4. Published online June 30, 2019
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DOI: https://doi.org/10.18858/smn.2019.10.1.1
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Abstract
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Now days, the use of specialized nutrition support has become a standard tool in the care of patients. With the development of specialized nutrition support, an interdisciplinary approach was essential to archive a goal. Fortunately, Nutritional support team (NST) consultation fee has been reimbursed under the national health insurance system since 2014. Overall, it might be true that there has been some progress in the NST’s activities. However, it is still questionable whether there was a positive effect in terms of quality or cost effectiveness compared to quantitative improvements. Before taking into consideration of the future of NST, we are going to look at the status of nutritional support practice and utility of NST in Korea. Upon this background, we hope to make constructive suggestions for a better future of NST.
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