JPEN. Journal of parenteral and enteral nutrition最新文献

{"title":"Association between specialized nutrition support and 90-day mortality relative to standard of care in malnourished adults with decompensated cirrhosis: A retrospective cohort study.","authors":"Katharina L Hupa-Breier, Laura Buttler, Claudia Seipt, Andrea Markowski, Marie Griemsmann, Tammo L Tergast, Birgit Kaufmann, Hannah Rieland, Heiner Wedemeyer, Benjamin Maasoumy, Andrea Schneider","doi":"10.1002/jpen.70066","DOIUrl":"10.1002/jpen.70066","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is common among patients with decompensated liver cirrhosis and linked to poor prognosis. Guidelines recommend intensified nutrition support e.g. parenteral nutrition, but evidence regarding safety and effectiveness is scarce. We aimed to investigate the impact of nutrition support, specifically parenteral nutrition, on mortality (primary end point) and on cirrhosis-specific complications (secondary end points) in patients with advanced liver cirrhosis.</p><p><strong>Methods: </strong>Consecutive malnourished patients with decompensated cirrhosis treated at our center between 2013 and 2018 were investigated. Fifty-three patients received specialized nutrition support; 33 received parenteral nutrition. The specialized nutrition support group (cohort 1) and the home parenteral nutrition group (cohort 2) were compared with patients without specific dietary support (standard-of-care group) after 1:1 and 1:2 propensity score matching, respectively. Mortality, hepatic encephalopathy, infections, and rehospitalization were investigated within 90 days.</p><p><strong>Results: </strong>Median baseline Model for End-Stage Liver Disease score (possible range 6-40 points) was 18 in cohort 1 and 16 in cohort 2. No impact of specialized nutrition support on the clinical outcome was detected. Between cohort 2 and standard of care, no differences in mortality and rehospitalization were observed. Whereas parenteral nutrition was associated with increased risk for bloodstream infections (hazard ratio [HR] = 21.3; P = 0.004), overall incidence of bacterial infections was comparable between groups (HR = 0.82; P = 0.45). Of note, the likelihood for hepatic encephalopathy was significantly reduced in cohort 2 in the multivariable competing risk model (HR = 0.28; P = 0.03).</p><p><strong>Conclusion: </strong>Home parenteral nutrition seems safe overall and may ameliorate the risk for hepatic encephalopathy in candidates for liver transplant.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"544-556"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential feeding alters hepatic circadian rhythm gene expression and lipid levels in septic mice.","authors":"Bo Yao, Yi-Jing Song, Wen-Jun Chen, Hao-Rao Li, Jing Sun, Jian-Yu Liu","doi":"10.1002/jpen.70081","DOIUrl":"10.1002/jpen.70081","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the effects and mechanisms of sequential feeding on lipid metabolism in a murine sepsis model.</p><p><strong>Methods: </strong>Septic mice were randomly assigned to a continuous or sequential feeding group. In the continuous group, mice were fed ad libitum day and night via using an automatic feeder. In the sequential group, mice received continuous feeding for the first 5 days, followed by physiological feeding starting on Day 6. Physiological feeding was limited to 20:00-08:00 to match the nocturnal feeding pattern of mice. On Day 14, blood samples were collected at 08:00 and 20:00 to measure serum cholesterol and triglycerides. Liver tissues were collected at 20:00 for transcriptomic analysis and hematoxylin and eosin (H&E) staining, and at both time points for circadian rhythm gene analysis using polymerase chain reaction (PCR) array.</p><p><strong>Results: </strong>In the sequential group, serum triglyceride and cholesterol levels were significantly lower at 20:00 than at 08:00; no such differences were observed in the continuous group. H&E staining revealed extensive hepatocellular steatosis in the continuous group. Four hundred and sixty one differentially expressed genes were identified between the two groups, with circadian rhythm as the most enriched pathway. PCR array revealed 14 differentially expressed circadian-related genes and transcriptional regulators between 08:00 and 20:00 in the sequential group, compared with only four in the continuous group.</p><p><strong>Conclusion: </strong>Sequential feeding modulates serum cholesterol and triglyceride levels in septic mice and preserves differential expression of some hepatic circadian rhythm-related genes at 08:00 and 20:00. However, continuous feeding attenuates the differential expression of these genes and is associated with severe hepatocellular steatosis.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"593-601"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to nutrition following neurosurgery: A descriptive cohort study.","authors":"Dale Palmer, Melissa Zhou, Suzie Ferrie","doi":"10.1002/jpen.70077","DOIUrl":"10.1002/jpen.70077","url":null,"abstract":"<p><strong>Background: </strong>Neurological trauma results in a state of hypermetabolism. Existing literature has explored barriers to adequate nutrition following traumatic brain injury. Despite clinical similarities, it remains unclear whether similar nutritional barriers are faced following both planned and emergency neurosurgical procedures. This study aimed to describe nutritional management, the prevalence of barriers to nutrition, and their association with selected patient outcomes among longer-stay patients undergoing neurosurgical procedures.</p><p><strong>Methods: </strong>Medical records were reviewed for hospitalised neurosurgery patients admitted >13 days, including a postoperative intensive care unit (ICU) stay ≥24 h, between January 2021 and June 2023. Demographic data, nutritional status (Subjective Global Assessment [SGA]), and documented barriers to adequate nutrition were collected. Multivariable linear regression was used to explore associations between variables.</p><p><strong>Results: </strong>Of the 166 eligible patients, 101 (60.8%) were seen by a dietitian and 86 had a SGA completed of which 21 developed hospital-acquired malnutrition. Barriers to nutrition were identified among 154 (92.8%) patients, with a median of 5.0 (3.0, 8.0) per patient. The most prevalent included procedural fasting (n = 100) and feeding tube problems (n = 90). Experiencing <math> <semantics> <mrow><mrow><mo>≥</mo></mrow> </mrow> <annotation><math display=\"inline\" altimg=\"urn:x-wiley:01486071:media:jpen70077:jpen70077-math-0001\" xmlns=\"http://www.w3.org/1998/Math/MathML\" wiley:location=\"equation/jpen70077-math-0001.png\"><mrow><mrow><mo>unicode{x02265}</mo></mrow></mrow></math></annotation></semantics> </math> 5 barriers was associated with an increased likelihood of ICU re-admission (p = 0.02) and hospital-acquired malnutrition (p = 0.04). Barriers to nutrition during ICU admission were associated with longer subsequent length of stay on the ward (p = 0.006).</p><p><strong>Conclusion: </strong>Longer-stay neurosurgical patients are a nutritionally vulnerable cohort with a high prevalence of barriers to nutrition. Further interventional research is needed to determine whether addressing these barriers leads to improved clinical outcomes.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"565-572"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practices, barriers, and opportunities for dietitians-nutrionists in critical care in Latin America: A cross-sectional study.","authors":"Mirta Crovetto, Solange Parra-Soto, Samuel Durán-Aguero, Karla Cordón-Arrivillaga, Marisa Canicoba, Leslie Landaeta-Díaz, Jhon Jairo Bejarano, Saby Mauricio, Edna J Nava-González, Valeria Carpio-Arias, Sheila Cerezo, Sonia Ivankovich, Alfonsina Ortiz, Beatriz Nuñez-Martinez, Eliana Romina Meza-Miranda, Gertrudis M Adrianza de Baptista, Marisela Morales, Melissa Miranda-Durán, Frank Carrera-Gil","doi":"10.1002/jpen.70074","DOIUrl":"10.1002/jpen.70074","url":null,"abstract":"<p><strong>Background: </strong>Dietitians-nutritionists (DNs) play a key role in intensive care units (ICUs), yet their scope of practice varies across settings. This study aimed to describe the professional practices of DNs working in ICUs in Latin America and to identify factors associated with their level of professional activity.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using an online survey targeting DNs working in ICUs across 18 Latin American countries. The survey included two questionnaires: one assessing professional functions and responsibilities, and another evaluating practices, dynamics, and resources for nutritional care.</p><p><strong>Results: </strong>A total of 223 responses were obtained, mainly from Argentina, Chile, Colombia, Peru, and Mexico. Respondents reported a median of 10 years of professional experience (interquartile range: 6-16). Most worked in high-complexity public hospitals (141 [63.2%]) and reported ≥40 h workweeks (144 [64.6%]); 137 (61.4%) held postgraduate degrees. Systematic participation in nutritional assessment, intervention, and monitoring was reported by 165 (74.0%), 183 (82.1%), and 168 (75.3%) respondents, respectively. Only 97 (43.5%) were authorized to prescribe nutritional therapy, with institutional policies identified as the main barrier. Academic involvement was limited, with 91 (41.7%) occasionally participating in teaching and 93 (42.1%) in research. The NRS-2002 was the most commonly used screening tool; only 16 (7.2%) reported access to indirect calorimetry, and 120 (53.8%) assessed muscle mass, mainly by anthropometry CONCLUSIONS: DNs in Latin America play an active role in ICU nutritional care but face important limitations in clinical autonomy, access to diagnostic tools, and academic participation.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"582-592"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal function impairment in children with intestinal failure receiving parenteral nutrition: A descriptive cohort study.","authors":"Amanda M Braga da Mata, Heitor Pons Leite, Eduardo F Hatanaka, Mariana Janiques Barcia Magalhães Fonseca, Marta Liliane de Almeida Maia, Giovana S G Sabio, Maria Fernanda C de Camargo, Paulo C Koch Nogueira","doi":"10.1002/jpen.70059","DOIUrl":"10.1002/jpen.70059","url":null,"abstract":"<p><strong>Background: </strong>Children with intestinal failure are at risk for kidney dysfunction; however, the contributing factors are not well established. We aimed to describe risk factors associated with glomerular and tubular renal dysfunction in children with intestinal failure.</p><p><strong>Methods: </strong>This retrospective cohort study assessed glomerular and tubular dysfunction in children receiving parenteral nutrition for intestinal failure at two subsequent time points. Glomerular function was assessed using the estimated glomerular filtration rate and urinary microalbumin/creatinine ratio. Tubular function was assessed using the urinary calcium/creatinine ratio and maximum tubular reabsorption of phosphate for estimated glomerular filtration rate. We tested the association between outcomes and ultrashort bowel, age at admission to the intestinal rehabilitation program, length of follow-up, prematurity, low birth weight, malnutrition, preserved colon in continuity, and ileocecal valve.</p><p><strong>Results: </strong>The study included 25 patients with a median age of 0.3 (0-14) years, of whom 14 (56%) were boys. Two patients had decreased estimated glomerular filtration rate (one at each time point). Microalbuminuria was observed in four children at time point 1 and persisted in one child at time point 2. Hypercalciuria occurred in 10 of 23 and 9 of 24 children at time points 1 and 2, respectively; 5 maintained this alteration at both time points. Reduced maximum tubular phosphate reabsorption/estimated glomerular filtration rate ratios were observed in 6 of 12 and 2 of 14 children at time points 1 and 2, respectively.</p><p><strong>Conclusion: </strong>Two-thirds of children with intestinal failure had renal dysfunction, represented by microalbuminuria, reduced estimated glomerular filtration rate, hypercalciuria, and phosphaturia.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"515-520"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum 25(OH)D and Life's Essential 8 score: A cross-sectional study.","authors":"Xingyu Yao, Yong Wang, Zhuoqun Hu","doi":"10.1002/jpen.70075","DOIUrl":"10.1002/jpen.70075","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases remain the leading cause of global mortality, and serum 25-hydroxyvitamin D (25(OH)D) deficiency has been identified as a potential contributing risk factor. The American Heart Association introduced Life's Essential 8, a comprehensive framework comprising eight core metrics for assessing cardiovascular health. However, current evidence on the association between serum 25(OH)D status and Life's Essential 8 score remains limited, particularly regarding potential nonlinear relationships. Therefore, this study aims to examine the association between serum 25(OH)D levels and cardiovascular health measured by Life's Essential 8 score.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 17,198 adults using data from the National Health and Nutrition Examination Survey 2007-2018. Life's Essential 8 score were calculated following standardized protocols. Statistical analyses included multivariable logistic regression, restricted cubic spline models, and mediation analysis.</p><p><strong>Results: </strong>Our analysis revealed a significant nonlinear association between serum 25(OH)D levels and Life's Essential 8 score, with an optimal threshold observed at approximately 127 nmol/L (β = 0.05, P < 0.001). This association persisted after adjusting for traditional cardiovascular risk factors (P < 0.05). Mediation analysis indicated that uric acid mediates approximately 7% of the indirect effect of the relationship between serum 25(OH)D and cardiovascular health. The results indicate that serum 25(OH)D status is associated with cardiovascular health both in direct and indirect effects.</p><p><strong>Conclusion: </strong>This study demonstrates a significant association between serum 25(OH)D levels and cardiovascular health, as quantified by Life's Essential 8 score. These findings emphasize the significance of optimal vitamin D supplementation being inversely related to CVD risk.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"557-564"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of arginine-enriched enteral nutrition on clinical outcomes with infectious events and muscle volume in critically ill patients: A systematic review and meta-analysis.","authors":"Masayuki Kaku, Chihiro Narita, Hiroyasu Murata, Minoru Yoshida, Kohei Yamada, Hideaki Sakuramoto, Ryo Yamamoto, Naoki Higashibeppu, Kensuke Nakamura, Joji Kotani","doi":"10.1002/jpen.70068","DOIUrl":"10.1002/jpen.70068","url":null,"abstract":"<p><strong>Background: </strong>Arginine is a conditionally essential amino acid that is deficient in catabolic states. However, the effects and safety of arginine-enriched enteral nutrition (EN) supplements in critically ill patients remain unclear. Therefore, the present systematic review and meta-analysis of randomized controlled trials (RCTs) investigated this issue.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis. We searched the PubMed, CENTRAL, and ICHUSHI databases from inception to October 3, 2024. RCTs comparing arginine-enriched EN supplements with placebo or standard composition nutrition supplements for critically ill patients were examined. The primary outcome was the incidence of infection. Secondary outcomes were mortality, length of intensive care unit stay, duration of mechanical ventilation, muscle volume, physical function, and adverse events. Risk of bias was assessed using Cochrane Risk of Bias 2. The certainty of evidence (CoE) was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated.</p><p><strong>Results: </strong>Twenty-three studies (n = 2311) that met the selection criteria were included in the meta-analysis. Arginine-enriched EN did not reduce the incidence of infection (RR, 0.98; 95% CI, 0.63-1.54; P = 0.93) or other outcomes. Only one study examined muscle volume. No RCTs evaluated physical function. CoE was mostly low, and heterogeneity was high.</p><p><strong>Conclusion: </strong>Arginine-enriched EN may not exert beneficial effects on the incidence of infection or other outcomes. However, because no studies have examined the administration of arginine alone and few RCTs investigated physical outcomes, such as muscle volume and physical function, further research is warranted.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"486-498"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for replacement of a balloon gastrostomy tube in infants and pediatric patients: The American Society for Parenteral and Enteral Nutrition.","authors":"Beth Lyman, Loren Berman, Kathleen Carr, Cailin Frank, Peggi Guenter, Rachel Kassel, Janet Kimble, Carol McGinnis, Silvana Oppedisano, Elizabeth A Paton, Gina Rempel, Derek S Wakeman, David D Church, Jacob T Mey, Sarah Peterson, Liam McKeever","doi":"10.1002/jpen.70080","DOIUrl":"10.1002/jpen.70080","url":null,"abstract":"<p><strong>Background: </strong>Balloon gastrostomy tube (BGT) placements are increasing due to their ability to facilitate care of medically complex children. Management for routine and nonroutine tube replacement, including verification of proper replacement, lacks standardization, varying widely among different institutions and settings. Currently, no overall standard of care exists for placement verification following BGT replacement, which can occur anywhere. This guideline provides recommendations on topics surrounding best practices, timing, and education confirming newly replaced BGTs.</p><p><strong>Methods: </strong>An interdisciplinary team developed key questions and performed a systematic search of the PubMed/MEDLINE, EMBASE, CINAHL, and Cochrane Central databases from January 2008 to October 2025. Recommendations were developed for questions concerning timing of routine BGT replacement, weighing the impact of comorbidities and extenuating circumstances, standard and additional methods to confirm BGT replacement position, confirmation of placement when the BGT is traumatically or accidentally dislodged, and how care bundles and clinician education around BGT replacement impact patient outcomes.</p><p><strong>Results: </strong>Three studies were included (one validation and two pre-post studies). Recommendations were made for when additional measures beyond aspiration of gastric contents (e.g., radiographic contrast study) are indicated, use of ultrasound in lieu of a contrast study, what care bundle components improve patient outcomes, and what topics should be covered in clinician education for BGT replacement confirmation.</p><p><strong>Conclusion: </strong>This guideline provides placement confirmation guidance for clinicians who perform routine and nonroutine BGT replacements, identifies areas for research, and suggests the use of care bundles to standardize care of this population. This paper was approved by the ASPEN Board of Directors.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"462-485"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between prescribed parenteral energy doses and the composite of clinical adverse events in adult patients after gastrointestinal cancer surgery: A retrospective cohort study.","authors":"Yoshikuni Kawaguchi, Kenta Murotani, Nahoki Hayashi, Satoru Kamoshita","doi":"10.1002/jpen.70084","DOIUrl":"10.1002/jpen.70084","url":null,"abstract":"<p><strong>Background: </strong>We aimed to compare the impact of prescribed parenteral energy on clinical outcomes in patients who exclusively received parenteral nutrition after gastrointestinal cancer surgery.</p><p><strong>Methods: </strong>We identified patients who exclusively received parenteral nutrition for ≥7 days after surgery using a medical claims database. Based on the mean parenteral energy doses during postoperative days 1-7, patients were divided into restricted-energy (5-10 kcal/kg/day), low-energy (10-20 kcal/kg/day), and standard-energy (20-30 kcal/kg/day) groups. The primary outcome was a composite of clinical adverse events, and secondary outcomes included in-hospital mortality, postoperative complications, declines in activities of daily living, hospital readmission, and length of hospital stay (LOS). Multivariable logistic and multiple regression analyses were employed using the restricted-energy group as the reference.</p><p><strong>Results: </strong>Of 18,294 eligible patients, 6727, 9760, and 1807 were classified into the restricted-, low-, and standard-energy groups, respectively. The adjusted odds ratio (95% confidence interval) for the composite outcome was 1.062 (0.972-1.161; P = 0.18) in the low-energy group and 1.093 (0.942-1.267; P = 0.24) in the standard-energy group. For in-hospital mortality, the adjusted odds ratio was 1.060 (1.057-1.062; P < 0.001) in the low-energy group and 1.281 (1.275-1.287; P < 0.001) in the standard-energy group. The adjusted regression coefficient (95% confidence interval) for LOS was 2.0 (0.7-3.3; P = 0.004) in the low-energy group and 3.2 (1.0-5.5; P = 0.005) in the standard-energy group. No significant differences were observed in other outcomes.</p><p><strong>Conclusion: </strong>Early postoperative higher energy doses were associated with increased in-hospital mortality and LOS.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"521-532"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional and metabolic considerations in PNAC.","authors":"Adibah Mohd Arshad","doi":"10.1002/jpen.70082","DOIUrl":"10.1002/jpen.70082","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"503-504"},"PeriodicalIF":4.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}