Total parenteral nutrition usage trends in the United States
This study examined how total parenteral nutrition (TPN) usage has changed in recent years, and whether a difference exists between teaching and non-teaching institutions.Materials and methods
Using the National Inpatient Sample (NIS) database, total discharges of patients who received TPN (ICD-9 99.15) from 2001 to 2014 were determined. The cohort was dichotomized for teaching and non-teaching institutions, and analyzed using the Z-test statistic.Results
Annual patients receiving TPN at all institutions increased significantly from 25,075 in 2001 to 33,435 in 2014 (P < 0.0001), peaking at 43,350 in 2012. Annual patients receiving TPN at teaching institutions increased significantly from 13,231 in 2001 to 24,630 in 2014 (P < 0.0001), peaking at 26,935 in 2012. Annual patients receiving TPN at non-teaching institutions decreased significantly from 11,844 in 2001 to 8805 in 2014 (P < 0.0001), peaking at 17,920 in 2011.Discussion
It is unclear why TPN usage trended upward in United States hospitals, and why TPN usage peaked and subsequently decreased in non-teaching institutions while continuing to uptrend in teaching institutions. Further inquiry is indicated to determine the etiology of this discrepancy.Conclusions
Utilization of TPN increased in the United States between 2001 and 2014, eventually decreasing in non-teaching institutions but not in teaching institutions.