Nutrición Hospitalaria (Feb 2003)
Nutrición parenteral domiciliaria (NPD): registro NADYA. Año 2000 Parenteral nutrition at home: NADYA register for 2000
Abstract
Objetivo: Análisis descriptivo y valoración de los datos registrados por el Grupo de Trabajo NADYA-SENPE de pacientes que han recibido nutrición parenteral domiciliaria (NPD) en nuestro país durante el año 2000. Material y métodos: Se han recopilado datos (epidemiológicos, diagnóstico, vía de acceso, complicaciones, reingresos hospitalarios, duración del tratamiento y evolución) a partir de un cuestionario previamente diseñado para ello. Los datos obtenidos del cuestionario se introdujeron en una base de datos para la ulterior gestión de los mismos. Resultados: Los datos correspondían a 67 pacientes (edad media de 5 ± 4 años para pacientes Aim: We analyze the registered data of home parenteral nutrition (HPN) in our country during the year 2000. Method: The data were collected through a previously designed questionnaire. Apart from epidemiological information, the form includes the disease to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, and progress. All data were processed and analysed by the co-ordinating team. Results: Fourten hospitals participated, and 67 pacientes were enrolled. Middle age was 5 ± 4 years for patients < 14 years old, and 48 ± 15 years for those ≥ 14 years old. The more prevalent diagnosis were: ischemic bowel (28.4%), neoplasm (16.4%), radiation enteritis (13.4%), motility disorders (7.5%), Crohn’s disease (2.9%), and other. The mean time on HPN was 7.5 ± 4.4 months. Tunelized catheter was the preferential route (77.6%), followed by the implantated one (20.9%). The intermittent method (nocturnal) was preferential (91.0%). Patients receive the formula from hospital pharmacy more frequently than from Nutriservice (71.5% versus 19.4%). The complications related to nutrition (0.32/100 days of HPN) included the infections (0,12 catheter sepsis/100 d of HPN), metabolic (0.06/100 d of HPN), mechanic (0.03/100 d of HPN) and electrolitic disorders (0.03/100 d of HPN). The readmission rate, for nutritional problems, was 0,3 hospitalizations /100 d of HPN. At the end of the year, 61.2% of the patients remained in the HPN program, 37.3% abandoned the treatment (due to death (40%), to progress to oral feeding (48%), and to progress to enteral nutrition (4%); and 1.5% of the patients were not follow up. Conclusions: This review illustrates that there is an increment in the registration of HPN patients in our country (1997: 0.7 pacients/10(6) habitants, 2000: 1.9 pacients/ 10(6) habitants), that vascular pathology is the more frequent diagnoses in HPN patients, and the rate of readmission and complications and the behaviour is similar to other series making this as a safe treatment in our place.