Table 1 Numbers, specialty distribution and indications for PN together with reasons for starting and stopping PN, before and after the introduction of a complete NST

From: Quality and safety impact on the provision of parenteral nutrition through introduction of a nutrition support team

Year NST status 2009 Before NST 2010 NST 1st year 2011 NST 2nd year 2012 NST 3rd year Total
Admissions in hospital, n 52 496 56 399 54 501 42 821 206 217
Referrals for PN, n 188 246 304 337 1 075
PN started, n (%) 180 (95) 230 (93) 279 (92) 303 (90) 992 (92)
Referring specialty, n (%)
 Gastrointestinal surgery 113 (60) 138 (56) 180 (59) 206 (61) 637 (59)
 Surgery, othera 22 (12) 42 (17) 28 (9) 31 (9) 123 (11)
 Gastroenterology 22 (12) 22 (9) 34 (11) 33 (10) 111 (10)
 Medicine, otherb 31 (16) 44 (18) 62 (20) 67 (20) 204 (20)
 Total 188 (100) 246 (100) 304 (100 337 (100 1075 (100)
Indications for PN where started, n (%)
 Insufficient oral/enteral intakec 20 (11)* 14 (6)* 21 (8)* 10 (3)* 65 (7)
 Unsafe to feed oral/enterallyd 12 (7) 9 (4) 9 (3) 22 (7) 52 (5)
 Gastrointestinal obstruction 43 (24) 53 (23) 77 (28) 79 (26) 252 (25)
 Malabsorptione 22 (12) 21 (9) 22 (8) 22 (7) 87 (9)
 Postoperative ileus or leak 73 (41) 104 (45) 128 (46) 134 (44) 439 (44)
 Inaccessible gutf 10 (6)* 29 (13)* 22 (8)* 36 (12)* 97 (10)
 Total 180 (100) 230 (100) 279 (100) 303 (100) 992 (100)
Reasons why PN was not started, n (%)
 Oral intake sufficient 2 (25) 5 (31) 8 (32) 12 (35) 27 (33)
 Enteral feeding established 2 (25) 6 (37) 15 (60) 16 (47) 39 (47)
 Patient refused PN 2 (25) 2 (13) 0 (0) 2 (6) 6 (7)
 Life expectancy <5 days 2 (25) 1 (6) 0 (0) 2 (6) 5 (6)
 Patient transferred 0 (0) 2 (13) 2 (8) 2 (6) 6 (7)
 Total 8 (100) 16 (100) 25 (100) 34 (100) 83 (100)
Reasons why PN was stopped, n (%)
 Oral diet established 95 (53) 128 (56) 166 (60) 178 (59) 567 (58)
 Enteral tube feeding 32 (18) 45 (20) 53 (19) 47 (16) 177 (18)
 Complicationsg 18 (10)** 7 (3)** 3 (1)** 7 (2)** 35 (4)
 Patient refused 0 (0) 5 (2) 3 (1) 4 (1) 12 (1)
 Patient died or dying 16 (9) 22 (10) 26 (9) 28 (9) 92 (9)
 Transfer for long-term PN 9 (5) 8 (4) 9 (3) 17 (6) 43 (4)
 Transfer to other hospital 10 (6) 15 (7) 19 (7) 22 (7) 66 (7)
 Total 180 (100) 230 (100) 279 (100) 303 (100) 992 (100)
  1. Abbreviations: NST, nutrition support team; PN, parenteral nutrition.
  2. *P=0.01, χ2-test. **P<0.001, Mantel–Haenszel χ2-test.
  3. aEar–nose–throat, gynaecology, neurosurgery, orthopaedic surgery, spinal surgery, trauma.
  4. Cardiology, endochrinology, haematology, metabolic diseases, nephrology, neurology, respiratory medicine, rheumatology.
  5. cGastroparesis.
  6. dAspiration, intraabdominal abscess, gastrointestinal perforation.
  7. eActive Crohn’s disease, post-chemotherapy mucositis, Clostridium difficile infection, protein-losing enteropathy, radiation enteritis, short bowel syndrome, enterocutaneous fistula.
  8. fTube placement contraindicated or not possible, tube blockage.
  9. gLine sepsis, thrombosis, pulmonary oedema, abnormal liver function tests, loss of intravenous access.