EFFICACY OF TOTAL PARENTERAL-NUTRITION IN A SERIES OF END-STAGE AIDS PATIENTS - A CASE-CONTROL STUDY

The aims of this study were to document the risks and benefits of tota l parenteral nutrition (TPN) by comparing two groups of patients with advanced HIV disease. This case-control study took place from June 199 2 through June 1994. Medical Records were the primary source of data. Bailey-Boushay House, a 24-h skilled nursing facility in Seattle, Wash ington was the resident location of participating patients. TPN was co mmonly used in this long-term care facility for persons with AIDS. Eig hty patients with AIDS, 40 of whom were receiving TPN and 40 of whom w ere not receiving TPN but who had central venous access (control group ) were chosen. No significant differences were found between the two g roups in the number of positive blood cultures (10% vs. 3%), however, the number of abnormal lab values was higher in the TPN group (6 vs. 4 ) (p < 0.05). The TPN group also gained an average of 2.2 kg in weight compared to an average loss of 1.4 kg in the control group (p < 0.05) ; the control group had a higher number of patients with weight loss > 10% of admit weight (28% vs. 8%) (p < 0.05). The length of stay was si milar between groups (91 vs. 77 days), as were several quality of life indicators. The conclusions of the investigators was that TPN did not appear to lead to clinically important positive or negative health ef fects when compared to a group not receiving TPN but with central veno us access. Benefits or detriments to certain subgroups of AIDS patient s may well exist that were not apparent in this study.