Home Enteral Nutrition in Adults—Nationwide Multicenter Survey

Abstract

Home enteral nutrition (HEN) is an important part of the health care system, with a growing population of patients around the world. The aim of our study was to analyze one of the largest cohorts of HEN patients to provide the most recent data available in European literature. A multicenter, nation-wide survey in the period of 1 January 2018–1 January 2019 was performed in Poland. Data concerning adult patients on HEN in 2018 during 1 year of observation time were analyzed: demographic characteristics, primary disease, technique of enteral feeding, diet formulation and amount of energy provided. A total of 4586 HEN patients (F: 46.7%, M: 53.3%) were included in the study. The primary diseases were: 54.5% neurological (17.4%—neurovascular, 13.7%—neurodegenerative), 33.9% cancer (20.2%—head and neck, 11.7%—gastrointestinal cancer), 2.5%-gastroenterology, 1.5%—inherited diseases. Of new registrations in 2018—cancer patients 46.3%, neurological patients 45.1%. The median age overall was: 64 yr., BMI-20.2 kg/m2, NRS 2002 score—4.28. A total of 65% of patients were treated with PEG, 11.6% with surgical gastrostomy, 14.3% with naso-gastric tube and 7% with jejunostomy. Boluses were the most common method of feeding (74.4%). Gravity flow was used in 17.6% and peristaltic pump was used in 8% patients. The median energy provision was 1278 kcal/day and 24 kcal/kg/day. The most commonly used diets were: isocaloric (28.1%), protein-enriched isocaloric (20%) and protein-enriched hypercaloric (12%). The median overall duration of HEN was 354 days, 615 days for neurological and 209 days for cancer patients. A number of new registrations of cancer patients was significant and long duration of HEN in this group is encouraging. A developing spectrum of enteral formulas available enables more specified nutritional interventions.

Prevalence and Trends in Percutaneous Endoscopic Gastrostomy Placement: Results From a 10-Year, Nationwide Analysis

“…A growing number of patients with cancer on HEN are observed in European studies. In Poland, 14% in 2013 ( 7 ) and 33.9% in 2018 were qualified for HEN due to oncological primary disease ( 24 ). Patients with HNC are a dominant group.…”

“…Nevertheless, there are different strategies for enteral nutritional routes. Gastrostomy is the most prevalent access in HEN in Poland (77% of patients) ( 5 ). However, other European studies show that nasogastric tubes (NGT) are more commonly used.…”

Organizational issues of home parenteral nutrition during COVID-19 pandemic: Results from multicenter, nationwide study

“…Although there is no national registry, we estimate that there are nearly 6000 HEN patients in Poland, more than 4500 reported in our previous study analyzing data from the year 2018. [25] .…”

How to Approach Long-term Enteral and Parenteral Nutrition

“…The main indications for HEN/HPN are summarized in Table 1. The most frequent indications for HEN are neurologic diseases and cancer, 3,5,6 whereas HPN is more often indicated for patients with short bowel syndrome, malabsorption, and gastrointestinal mechanical obstruction. 7 Nevertheless, the indication for HEN/HPN should be evaluated on a case-by-case basis, by a multidisciplinary team, because each patient has a different baseline prognosis that is independent of nutritional support.…”