동종 조혈모세포이식을 받은 환자에서 다학제적인 영양집중지원팀 자문을 통한 약사 기반 정맥영양 관리의 영양학적 및 임상적 영향
The Nutritional and Clinical Impact of Pharmacist-Based Parenteral Nutrition Care via the Consultation of a Multidisciplinary Nutrition Support Team in Adults who Have Undergone Allogeneic Hematopoietic Stem Cell Transplantation
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Background : The purpose of this study was to compare the nutritional and clinical impact of parenteral nutrition (PN) depending on nutrition support team (NST) consultation for patients who have undergone the allogeneic hematopoietic stem cell transplant (HSCT). Methods : This was a retrospective study of adult patients who have undergone allogeneic HSCT June 2013 May 2017 and received PN for more than three days. Patients were divided into two groups depending on if they had consultation on the NST; the Non-NST group (n=61) and the NST group (n=41). And these two groups were comparatively analyzed relative how the supply of PN impacts improvement of nutritional status and clinical outcomes. Results : Demographic characteristics were similar between the two groups except age. Patients in the Non-NST group had significantly fewer days of PN administration (p 0.001) and shorter length of hospital stay (LOS) (p=0.005). Subgroups were analyzed for patients with LOS less than 30 days. Comparing LOS and days of PN administration showed no significant differences between the Non-NST group (n=27), and the NST group (n=11). As a result of analyzing the nutritional supply, calories were similar (p=0.775) and the amount of protein was significantly higher in the NST group, 1.0±0.28 vs. 1.2±0.22 g/kg/day (p=0.032). Also, the ratio of non-protein calories to nitrogen showed significant difference (p=0.014). Change in serum concentration of albumin during the PN administration period increased in the NST group at -0.14±0.45 vs. 0.16±0.42 (p=0.082) but was not significant. Incidence of acute graftversus- host disease, neutropenic fever, sepsis, re-hospitalization and 100-day mortality did not show significant difference, but time to platelet engraftment showed a more rapid trend in the NST group (p=0.088). Conclusions : The supply amount and proportion of protein in allogeneic HSCT patients administered PN through NST consultation was high, and positively impacted the albumin nutrition status.
Abstract
Background : The purpose of this study was to compare the nutritional and clinical impact of parenteral nutrition (PN) depending on nutrition support team (NST) consultation for patients who have undergone the allogeneic hematopoietic stem cell transplant (HSCT). Methods : This was a retrospective study of adult patients who have undergone allogeneic HSCT June 2013 May 2017 and received PN for more than three days. Patients were divided into two groups depending on if they had consultation on the NST; the Non-NST group (n=61) and the NST group (n=41). And these two groups were comparatively analyzed relative how the supply of PN impacts improvement of nutritional status and clinical outcomes. Results : Demographic characteristics were similar between the two groups except age. Patients in the Non-NST group had significantly fewer days of PN administration (p 0.001) and shorter length of hospital stay (LOS) (p=0.005). Subgroups were analyzed for patients with LOS less than 30 days. Comparing LOS and days of PN administration showed no significant differences between the Non-NST group (n=27), and the NST group (n=11). As a result of analyzing the nutritional supply, calories were similar (p=0.775) and the amount of protein was significantly higher in the NST group, 1.0±0.28 vs. 1.2±0.22 g/kg/day (p=0.032). Also, the ratio of non-protein calories to nitrogen showed significant difference (p=0.014). Change in serum concentration of albumin during the PN administration period increased in the NST group at -0.14±0.45 vs. 0.16±0.42 (p=0.082) but was not significant. Incidence of acute graftversus- host disease, neutropenic fever, sepsis, re-hospitalization and 100-day mortality did not show significant difference, but time to platelet engraftment showed a more rapid trend in the NST group (p=0.088). Conclusions : The supply amount and proportion of protein in allogeneic HSCT patients administered PN through NST consultation was high, and positively impacted the albumin nutrition status.
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