Complications of TPN in cirrhotic population

Document Type

Conference Proceeding

Publication Date

7-4-2025

Publication Title

Gut

Abstract

Background This retrospective study seeks to illuminate complications in cirrhotic patients receiving TPN. TPN is generally started in patients with cirrhosis due to moderate to severe malnutrition. TPN-associated decompensation can be Serious and even progress to the liver. In our study, we look for complications due to decompensation and its contribution to overall mortality. Methods A retrospective chart review was conducted of all adults (18 years or older) at our center (2014-2024) with a history of Cirrhosis while on TPN. Data on basic patient demographics, indication for TPN, Duration of TPN therapy, changes in TPN formulation, and mortality were collected. Results In the study, a total of 12 107 patients had cirrhosis at the time of TPN initiation. Mortality was seen in 9 12 cirrhotics as compared to 43 95 non-cirrhotics. 4 12 cirrhotics had line infection, 0 12 had line clots, 7 12 had worsening ascite. A statistically significant difference in mortality was not observed. The association between cirrhosis and time from peak LFT to death was significant with p- 0.025 in which cirrhotics had a longer time between peaking LFT with 240 days compared to 70.55 days in non-cirrhotic. Conclusions Our findings suggest that TPN is associated with decompensation with ascites being the most common complication likely in the setting of volume overload. However, mortality is not significantly associated with pre-existing cirrhosis, rather cirrhosis had a larger difference between peak value and death. This can indicate that cirrhotic decompensation generally occurs slowly over time whereas non-cirrhotic generally die of liver failure which has a short course till death. The size of the study is extremely small and the external validity of the data can be questionable. This underscores the need for further research to identify an association between cirrhosis and TPN..

Volume

74

Issue

Suppl_3

First Page

A235

Last Page

A235

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