Nutrition provided during the final weeks to patients with non-gastrointestinal solid malignancies.

Cancer End of life Enteral nutrition Palliative care unit Parenteral nutrition

Journal

Clinical nutrition ESPEN
ISSN: 2405-4577
Titre abrégé: Clin Nutr ESPEN
Pays: England
ID NLM: 101654592

Informations de publication

Date de publication:
10 2023
Historique:
received: 10 12 2022
revised: 25 05 2023
accepted: 25 07 2023
medline: 25 9 2023
pubmed: 23 9 2023
entrez: 22 9 2023
Statut: ppublish

Résumé

Data regarding the delivery of nutrition and nutritional infusions to patients with terminal cancer remain limited; therefore, this real-world analysis investigated differences in nutrition delivery and infusion statuses for patients with terminal-stage cancers. Patients who had died following hospitalization for more than seven days due to neoplasms between April 2014 and December 2018 were identified using the medical claims database of Japan. Data regarding oral diets, enteral feeding, infusion volumes, and infusion energies were extracted. The maximum observation period was 28 days prior to patient death. A total of 12,908 patients were included in our analysis. The proportion of patients without dietary or enteral nutrition increased closer to their dates of death. Observations were recorded at 28 (18.9%), 21 (20.9%), 14 (24.6%), 7 (33.0%), and 0 (80.2%) days prior to death. The infusion volumes given to the patients, as well as their energy contents, decreased near death (P-value for the trend <0.001). Our study revealed the current status of nutritional therapy for patients with terminal cancer in Japan. The number of patients receiving only parenteral nutrition increased near death, while the amount of nutritional intake was low.

Sections du résumé

BACKGROUND & AIMS
Data regarding the delivery of nutrition and nutritional infusions to patients with terminal cancer remain limited; therefore, this real-world analysis investigated differences in nutrition delivery and infusion statuses for patients with terminal-stage cancers.
METHODS
Patients who had died following hospitalization for more than seven days due to neoplasms between April 2014 and December 2018 were identified using the medical claims database of Japan. Data regarding oral diets, enteral feeding, infusion volumes, and infusion energies were extracted. The maximum observation period was 28 days prior to patient death.
RESULTS
A total of 12,908 patients were included in our analysis. The proportion of patients without dietary or enteral nutrition increased closer to their dates of death. Observations were recorded at 28 (18.9%), 21 (20.9%), 14 (24.6%), 7 (33.0%), and 0 (80.2%) days prior to death. The infusion volumes given to the patients, as well as their energy contents, decreased near death (P-value for the trend <0.001).
CONCLUSIONS
Our study revealed the current status of nutritional therapy for patients with terminal cancer in Japan. The number of patients receiving only parenteral nutrition increased near death, while the amount of nutritional intake was low.

Identifiants

pubmed: 37739697
pii: S2405-4577(23)01190-7
doi: 10.1016/j.clnesp.2023.07.085
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

494-500

Informations de copyright

Copyright © 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None declared.

Auteurs

Tomoyuki Nonogaki (T)

Department of Pharmacy, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan.

Keisuke Maeda (K)

Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Nutrition Therapy Support Center, Aichi Medical University Hospital, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan. Electronic address: kskmaeda1701@gmail.com.

Akio Shimizu (A)

Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Health Science, Faculty of Health and Human Development, The University of Nagano, 8-49-7, Nagano, Japan.

Junko Ueshima (J)

Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Nutritional Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa, Tokyo 141-8625, Japan.

Ayano Nagano (A)

Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Nursing Care, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazuyamanaka-cho, Nishinomiya, Hyogo 663-821, Japan.

Ryoko Kato (R)

Department of Pharmacy, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan.

Yuria Ishida (Y)

Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Nutrition, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.

Remi Yamanaka (R)

Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Dentistry and Oral Surgery, Aichi Medical University 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.

Yosuke Yamanaka (Y)

Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Dentistry and Oral Surgery, Aichi Medical University 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.

Naoharu Mori (N)

Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Nutrition Therapy Support Center, Aichi Medical University Hospital, Japan.

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