A240 home parenteral nutrition in older versus younger patients: clinical characteristics and outcomes

Abstract Background There is a demographic shift toward older patients receiving home parenteral nutrition (HPN) but there is little data on their clinical characteristics and outcomes versus younger HPN patients. Aims The objective of this study was to determine if there are any differences between older (> 60 years) and younger (18–59 years) HPN patients in regard to HPN indications, prescriptions and outcomes over the first 2 years receiving HPN. Methods This was a retrospective analysis of prospectively collected data from HPN adult patients entered in the password protected web-based Canadian HPN Registry. New HPN patients enrolled between 2003 and 2017 and receiving HPN for 2 years were selected from 8 participating programs across Canada. Data included demographics, anthropometrics, PN prescriptions, line sepsis events, survival and quality of life based on the Karnofsky Performance Status (KPS). Results 402 patients met the inclusion criteria: 184 patients were 60 years old or above (older group) and 219 patients were between 18 and 59 years old (younger group). Around 64% of both groups were female. There were no significant differences in the main indications for HPN, body mass index (BMI), and PN prescriptions at baseline. At 2-years, younger patients received more calories from PN than older patients (27.88 vs 19.56 Kcal/kg respectively, p <0.001) but BMI remained comparable between groups. There were less line sepsis in the older group versus the younger group (20% vs 36%, p=0.0023) but 78% of younger patients remained alive versus 69 % in the older group (p=0.0401). In those alive, the proportion of patients remaining on HPN was comparable (older group: 77%; younger; group 81%, p=0.4709) and the proportion of patients with a reasonable quality of life (KPS > 60) was similar (older group: 58%; younger group: 63%, p=0.2156). Conclusions Older HPN patients have similar clinical characteristics as younger patients but with reduced line sepsis events and higher 2-year mortality. Funding Agencies Ontario Medical Supply, Takeda, Fresenius Kabi and Baxter Inc