Nutrition risk stratification and metabolic disorders in patients on parenteral nutrition.
Rodrigo Luis da Silveira Silva, Ranna Rayssa Leal Dos Santos, Helder Cardoso Tavares and 3 others
PMID 40215353WHAT IT FOUND
Death, glucose, potassium and phosphorus disorders did not differ between moderate and severe nutritional risk groups.
The severe group had more magnesium disorders, and sodium disorders were higher only after considering BMI, access and stay.
Key findings
01The severe risk group had significantly more magnesium disorders than the moderate risk group (p = 0.007), with an adjusted relative risk of 7.58 (2.33 to 24.6) (p = 0.001); each 1-point increase in score was also associated with an adjusted relative risk of 2.38 (1.34 to 4.24) (p = 0.003).
02Sodium disorders were more frequent in the severe risk group (p = 0.054), and the adjusted relative risk was 4.88 (1.5 to 16.2) (p = 0.009), but this was not significant when the score was analyzed continuously (1.4, 0.84 to 2.40; p = 0.196).
03There was no difference between groups for death or for glucose, potassium and phosphorus disorders.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Retrospective convenience sample from one hospital, with 84 patients, so selection bias and limited generalisability are possible. Data collection was interrupted during critical periods of the COVID-19 pandemic, which may have influenced significance and limited some data. All patients were already at nutritional risk (NRS 2002 score of 3 or more), so the study did not compare them with patients without nutritional risk. There was no follow-up after discharge to assess recurrence of metabolic disorders. The sodium finding was significant only after adjustment and not when the score was analyzed continuously. Because this was an observational cohort, it can show association but not prove that parenteral nutrition or the score caused the disorders.
Declared interests
The study was partially financed by CAPES Finance Code 001 and CNPQ process 401923/2024-0. No other conflicts of interest were stated.
The easy way to misread this
Do not read the adjusted sodium relative risk of 4.88 as proof that severe nutritional risk causes sodium disorders. The study was observational, and the sodium association was not significant when the score was analyzed continuously.