Routine laboratory parameters to support decision on parenteral nutrition in palliative care

Author(s)
Lea Kum, Elisabeth Lucia Zeilinger, Dagmar Vohla, Anna Kitta, Nadine Brunevskaya, Feroniki Adamidis, Franziska Ecker, Eva Katharina Masel, Brigitte Mayr-Pirker, Alexa Meyer, Bärbel Sturtzel, Gudrun Kreye, Matthias Unseld
Abstract

Introduction: Parenteral nutrition (PN) is widely used in palliative care (PC), but there is limited evidence to support its use at the end of life (EOL). This aim of this was to investigate the relationship between routine laboratory parameters and survival in patients receiving PN, and to develop a decision tree model to support clinicians decide whether to start or forgo PN. Methods: The laboratory parameters of 113 patients with advanced diseases who were admitted to a specialized palliative care unit (PCU) were analyzed at two points in time: T0 = before PN, T1 = two weeks after initiation of PN. Univariate Mann-Whitney U-tests and multivariate linear regression models, as well as a decision tree analysis were computed; all in relation to survival time. Results: The final regression model was significant with p = 0.001 (adjusted R2 = 0.15) and included two predictors for survival time after PN initiation: the CRP/albumin ratio and urea at T1 (ps = 0.019). Decision tree analysis revealed three important predictors for classification of survival time after PN initiation: CRP, urea, and LDH (all at T0). Discussion: The decision tree model may help to identify patients likely to benefit from PN, thus supporting the clinical decision whether or not to start PN.

Organisation(s)
Department of Clinical and Health Psychology
External organisation(s)
Akademie für Altersforschung am Haus der Barmherzigkeit, Paracelsus Medizinische Privatuniversität (PMU), Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Medizinische Universität Wien
Journal
Frontiers in Nutrition
Volume
10
ISSN
2296-861X
DOI
https://doi.org/10.3389/fnut.2023.1173106
Publication date
11-2023
Peer reviewed
Yes
Austrian Fields of Science 2012
302058 Palliative medicine, 303009 Nutritional sciences
Keywords
ASJC Scopus subject areas
Food Science, Nutrition and Dietetics, Endocrinology, Diabetes and Metabolism
Portal url
https://ucris.univie.ac.at/portal/en/publications/routine-laboratory-parameters-to-support-decision-on-parenteral-nutrition-in-palliative-care(9c7b9aae-a2da-44f0-856a-530316881907).html