Comparison of effectiveness, safety, and costs of standardized and customized parenteral nutrition support among gastric cancer patients after gastrectomy: a retrospective cohort study

Background and Objectives: To compare the effectiveness, safety, and costs of commercial standardized multi-chamber bag and customized compounded total parenteral nutrition (TPN) among gastric cancer patients after gastrectomy. Methods and Study Design: A retrospective cohort study was conducted among 64 gastric cancer patients who underwent gastrectomy from 2014 to 2016 in a tertiary teaching hospital in Beijing, China. Patients were categorized into standardized (s-TPN) and customized TPN (c-TPN) groups based on their TPN order after gastrectomy. Patients were followed up until discharge. The effectiveness measures (body mass index (BMI) and albumin) and safety measures (liver and renal functions and electrolytes) were compared before TPN started and after TPN finished within and between the two groups. The length of hospital stay and costs were compared between the two groups. Results: There were no significant differences between the two groups in BMI preservation, metabolic complications, the length of hospital stay and costs, except that both total bilirubin (Tbil) and direct bilirubin (Dbil) were significantly higher in the s-TPN group than c-TPN (p<0.05). Conclusions: There were no significant differences in effectiveness and safety measures, the length of hospital stay and costs between s-TPN and c-TPN groups, except that s-TPN group was more likely to lead to parenteral nutrition-associated liver disease (PNALD). More studies are needed to confirm the findings of this study in other healthcare settings and study populations.