Thoracic Research and Practice
Original Article

Does Total Parenteral Nutrition Increase the Mortality of Patients with Severe Sepsis in the ICU?

1.

Unit of Respiratory Intensive Care, Süreyyapaşa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, İstanbul, Turkey

2.

Department of Pulmonary Medicine, İstanbul Medeniyet University Faculty of Medicine, İstanbul, Turkey

3.

Department of Pulmonary Medicine, Yedikule Chest Diseases and Thoracic Surgery Teaching and Research Hospital, İstanbul, Turkey

Thorac Res Pract 2015; 16: 53-58
DOI: 10.5152/ttd.2015.4323
Read: 2356 Downloads: 1316 Published: 18 July 2019

Abstract

OBJECTIVES: We aimed to evaluate the independent association between total parenteral nutrition (TPN) and nosocomial infection and intensive care unit (ICU) mortality in patients with severe pulmonary sepsis.

 

MATERIAL AND METHODS: The present study was designed as a retrospective observational cohort study. We enrolled all patients with severe sepsis due to pulmonary infections who stayed more than 24 h in the respiratory ICU between January 2009 and December 2010. We recorded demographic characteristics, ICU severity scores, Acute Physiologic and Chronic Health Evaluation II (APACHE II) and first day Sequential Organ Failure Assessment (SOFA) score in the ICU, TPN because of intolerance to enteral feeding, ICU data, and mortality. To evaluate the risk factors for mortality, we performed adjusted logistic regression test for TPN, nosocomial infection, and SOFA in the model.

 

RESULTS: Five hundred and fifty patients (males=375, females=175) with severe sepsis were involved in the study during the study period. The median and interquartile range (IQR) of age, APACHE II, and SOFA score at the time of admission to the ICU were 65 years (53-73), 20 (16-25), and 4 (3-6), respectively. Mortality rate was 18% (n=99). Adjusted odds ratio (OR), confidence intervals (CI) 95%, and p values of TPN, nosocomial infection, and first day SOFA score for mortality were as follows: OR:3.8, CI:2.3-6.1, p<0.001; OR:2.4, CI: 1.4-3.9, p<0.001; and OR: 1.3, CI:1.2-1.4, p<0.001, respectively.

 

CONCLUSION: Nosocomial infection and the need for TPN because of intolerance of enteral nutrition (EN) is associated with a higher mortality rate in patients with severe sepsis in the ICU. Rational use of antibiotics and application of hospital acquired infection control program will further reduce mortality.

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