PD776 - REAL-WORLD CLINICAL OUTCOMES OF HOME PARENTERAL NUTRITION IN MALIGNANT BOWEL OBSTRUCTION: A 12-YEAR RETROSPECTIVE STUDY FROM THAILAND

PD776

REAL-WORLD CLINICAL OUTCOMES OF HOME PARENTERAL NUTRITION IN MALIGNANT BOWEL OBSTRUCTION: A 12-YEAR RETROSPECTIVE STUDY FROM THAILAND

P. Talkijkul^1,*, O. Pichitchaipitak², N. Tontrakulrath¹, D. Warodomwichit¹

¹Division of Nutrition and Biochemical Medicine, Department of Medicine, ²Department of Nursing , Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Rationale: Home parenteral nutrition (HPN) is recommended for selected patients with malignant bowel obstruction (MBO), but evidence in Asian populations is limited. This study assessed HPN outcomes in Thailand.

Methods: This single-center retrospective study included adults with malignancy evaluated for HPN due to MBO at Ramathibodi Hospital between 2012 and 2024. Clinical and HPN-related data were extracted from electronic medical records. Overall survival was analyzed using Kaplan–Meier methods and multivariable Cox models. Longitudinal nutritional indices were analyzed using linear mixed-effects models. Hospitalization and complication rates were compared by HPN status.

Results: Among 178 assessed patients, 128 were eligible for HPN. Median age was 61 years (IQR 50–69), 65% were female, and 74% had gastrointestinal malignancies. Baseline characteristics were largely comparable, although the HPN group more frequently received systemic chemotherapy and had higher baseline Nutritional Risk Index and Prognostic Nutritional Index. Median survival was longer in the HPN than in the non-HPN group (3.25 vs 1.22 months), with 3-month survival rates of 58.3% and 18%, respectively. In multivariable analysis, younger age and systemic anticancer therapy were associated with longer survival, whereas non-initiation of HPN was the strongest predictor of poor survival (HR 3.31, 95% CI 2.17–5.04). During follow-up, HPN was associated with higher Prognostic Nutritional Index and serum albumin levels. Hospitalization rates were higher in the HPN group, without an increase in serious complications.

Image:

Conclusion: In this real-world study from Thailand, HPN was associated with modest improvements in survival and nutritional status in patients with MBO, without a marked increase in serious complications. Given the limited survival benefit, careful patient selection remains essential.

Disclosure of Interest: None declared