EVALUATION OF THE PARENTERAL NUTRITION SERVICES IN HOSPITAL PULAU PINANG

Parenteral nutrition (PN) has been practiced in Hospital Pulau Pinang, Malaysia since 1986. However, there is no published data on the cost, complications and outcome of patients receiving PN in this hospital. A retrospective study was carried out to evaluate the cost, complications and outcome of PN. Data were obtained from patient medical records and analysed using SPSS version 11. From 2003 to 2005, 429 PN cases were evaluated. Of the PN cases, 65% were neonates, 28.2% adults and 6.8% paediatric, where 60.8% of patients were male and 38.5% were female. Malay patients constituted 57.3%, Chinese 30.8% and Indian 11.9%. The reasons for PN were feeding intolerence (86.7%), oral intake restrictions (9.3%), poor oral intake (1.4%) and others (2.6%). The average cost for PN in a neonate was found to be RM185 ± 69, RM 233 ± 126 for a paediatric patient and RM 235 ± 107 for an adult. PN-associated complications were bacterial sepsis (30.4%), metabolic acidosis (13.0%), catheter dislodgment (8.7%), long line swelling (8.7%), hepatic complication (21.8%), long line blockage (4.4%) and catheter-related infection (13.0%). A total of 82.7% of cases tolerated oral nutrition after PN, 7.4% expired, 5.3% developed PN complications and others were discharged, transferred to other ward, transferred to another hospital, or discharged at own risk (0.3%). The study showed a significant difference in the cost of PN in each group of patients (p = 0.002). We concluded that PN services in Hospital Pulau Pinang were associated with low PN-related complications and good outcomes.