Clinical Outcomes Associated with Parenteral Nutrition Caloric Provision in Geriatric Patients with Infectious Colitis

초록

Background/Objectives: Malnutrition is a critical determinant of adverse outcomes in geriatric patients. Infectious colitis, which often requires hospitalization due to dehydration and poor oral intake, frequently necessitates parenteral nutrition (PN) when enteral feeding is not feasible. However, evidence regarding the optimal caloric threshold for PN in geriatric patients with infectious colitis remains limited. Methods: In this single-center retrospective observational study, we analyzed 278 geriatric patients (>= 65 years) admitted with infectious colitis to a tertiary hospital between 2008 and 2018. Patients hospitalized for more than 7 days or with alternative colitis etiologies were excluded. Daily PN caloric intake was categorized as >1000 kcal/day or <= 1000 kcal/day. Clinical and laboratory data were collected, and logistic regression was used to identify risk factors for prolonged hospitalization (>4 days). Results: Patients receiving > 1000 kcal/day PN had a significantly shorter mean length of stay compared with those receiving <= 1000 kcal/day (3.8 +/- 1.5 vs. 4.2 +/- 1.8 days, p = 0.03). In multivariable analysis, inadequate caloric intake (OR 1.90, 95% CI 1.08-3.34, p = 0.03), admission from a long-term care facility (OR 5.65, 95% CI 1.11-28.87, p = 0.04), elevated ESR (OR 1.74, 95% CI 1.03-2.94, p = 0.04), and lymphopenia (OR 1.95, 95% CI 1.06-3.61, p = 0.03) were independently associated with prolonged hospitalization. No significant difference in in-hospital mortality was observed between groups. Conclusions: Adequate PN supplementation exceeding 1000 kcal/day was associated with a shorter hospital stay in geriatric patients with infectious colitis.

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