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Home enteral nutrition: outcomes relative to indication.

BACKGROUND
Home enteral nutrition (HEN) is a life-sustaining therapy for patients who are unable to meet nutrient needs by oral intake, who have a functional gastrointestinal (GI) tract, and who are able to remain in their own home. The objective of this study was to identify whether the indication for HEN is related to reason for discharge from a HEN program.


METHODS
A retrospective chart review of all patients admitted to the multidisciplinary Northern Alberta Home Enteral Nutrition Support Program between January 1, 1999 and January 1, 2005 was performed. Detailed information on the indication for HEN, length of time on program, and reason for discharge was collected and statistically analyzed.


RESULTS
Over the 6-year period, 727 adult patients were admitted. Major diagnostic categories for HEN were cancer, neurological disorders, and GI disorders. Median duration of HEN for cancer patients was 122 (range, 1-1259) days, duration for neurological disorders was 187 (range, 1-1752) days, and duration for GI disorders was 161 (range, 1-1849) days. Death was the main reason for discharge in patients with cancer and neurological disorders. Patients with GI disorders were most likely to initiate oral intake and least likely to be discharged because of death.


CONCLUSIONS
Indications for HEN are related to outcome-specifically, time to discontinuation of enteral nutrition and reason for discharge, including return to oral intake and death.