Total parenteral nutrition usage trends in the United States

Introduction: 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.