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• W2114956875 abstract "Parenteral nutrition (PN) use in hospitalized patients has more than tripled in the U.S. from 1993 to 2010 according to statistics from the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ) (see Figure 1).1 Total number of hospital discharges with the ICD-9 code of 99.15, parenteral nutrition, 1993–2011. National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ). http://hcupnet.ahrq.gov/. Accessed June 26, 2013. Even when normalized for the total number of hospital discharges, the use of PN has more than doubled in that time (0.4% vs 0.94% of total discharges) according to HCUPnet NIS database. In mid-2010 widespread PN component shortages began and continue today with multiple macro- and micronutrient additives being unavailable for months to years. The A.S.P.E.N. Clinical Practice Committee, its PN Drug Shortage Subcommittee, and the Public Policy Committee were interested in determining whether the growth in use of PN for hospitalized patients had continued despite these component shortages. Just recently, the HCUP NIS 2011 data became available and upon review it is clear that PN use has decreased. This becomes particularly striking when the 2011 PN use data are normalized for total discharges (see Figure 2). Parenteral nutrition utilization trends (%) when normalized for total discharges. Derived from HCUP data for PN use (2011). Percent of total number of discharges calculated as Perhaps this decrease in PN use can be attributed to other factors such as stricter compliance with A.S.P.E.N. PN indications guidelines, provider perceptions of lack of benefit or increased harm related to PN, or as a cost-cutting measure. Clearly, this decrease in PN use is based only on a single year limiting any definitive conclusions and, while this decrease in use cannot yet be causally linked to PN component shortages, it is a concerning temporal association. As the 2012 and 2013 data become available, A.S.P.E.N. will be watching these trends carefully. A.S.P.E.N will also continue to assist in the resolution of PN component shortages. Only when the shortages of all PN components are resolved will we begin to understand the full impact of the shortages on patient outcomes, including the possibility that shortages could contribute to or predispose to hospital-acquired malnutrition—another issue we are monitoring." @default.
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• W2114956875 date "2013-11-13" @default.
• W2114956875 modified "2023-10-14" @default.
• W2114956875 title "Parenteral Nutrition Utilization" @default.
• W2114956875 doi "https://doi.org/10.1177/0148607113511273" @default.
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