title: Commercial enteral formulas and nutrition support teams improve the outcome of home enteral tube feeding.
abstract: BACKGROUND
  The benefits of home enteral tube feeding (HETF) provided by nutrition support teams (NSTs) have been questioned recently, given the growing costs to the healthcare system. This study examined the effect of a specialized home enteral nutrition program on clinical outcome variables in HETF patients.
  
  
  METHODS
  The observational study included 203 patients (103 women, 100 men; mean age 52.5 years) receiving HETF with homemade diets for at least 12 months before starting a specialized home nutrition program for another 12 months consisting of provision of commercial enteral formulas and the guidance of an NST. Both study periods were compared regarding the number of hospital admissions, length of hospital and intensive care unit (ICU) stay, and costs of hospitalization.
  
  
  RESULTS
  A specialized HETF program significantly reduced the number of hospital admissions and the duration of hospital and ICU stays. The need for hospitalization and ICU admission was significantly reduced, with odds ratios of 0.083 (95% confidence interval, 0.051-0.133, P < .001) and 0.259 (95% confidence interval, 0.124-0.539, P < .001), respectively. Specialized HETF was associated with a significant decrease in the prevalence of pneumonia (24.1% vs 14.2%), respiratory failure (7.3% vs 1.9%), urinary tract infection (11.3% vs 4.9%), and anemia (3.9% vs 0%) requiring hospitalization. The average yearly cost of hospital treatment decreased from $764.65 per patient to $142.66 per year per patient.
  
  
  CONCLUSIONS
  The specialized HETF care program reduces morbidity and costs related to long-term enteral feeding at home.
authors.affiliation: Nutrimed Medical Corporation, Krakow, Poland. klek@poczta.onet.pl
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Klek
authors.forename: Piotr
authors.initials: P
authors.lastname: Szybinski
authors.forename: Marek
authors.initials: M
authors.lastname: Sierzega
authors.forename: Kinga
authors.initials: K
authors.lastname: Szczepanek
authors.forename: Magdalena
authors.initials: M
authors.lastname: Sumlet
authors.forename: Monika
authors.initials: M
authors.lastname: Kupiec
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Koczur-Szozda
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Steinhoff-Nowak
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Figula
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kowalczyk
authors.forename: Jan
authors.initials: J
authors.lastname: Kulig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D003132:Commerce; D004032:Diet; D004750:Enteral Nutrition / Q000191:economics / Q000379:methods*; D005260:Female; D005526:Food, Formulated; D017048:Health Care Costs; D006699:Home Care Services / Q000191:economics; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010348:Patient Care Team; D011014:Pneumonia / Q000453:epidemiology / Q000517:prevention & control; D015995:Prevalence; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000517:prevention & control; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control; D055815:Young Adult