Parenteral Nutrition–Associated Liver Disease in Adult Inpatients Receiving Commercial Premixed Parenteral Nutrition for More Than 2 Weeks

Background: Long-term use of parenteral nutrition (PN) may elicit complications, including PN-associated liver disease (PNALD), which may yield critical outcomes. This study intended to investigate the development of complications associated with commercial premixed PN in adult patients. Methods: Adult patients who received nutrition support with commercial PN without enteral intake for >14 consecutive admission days were included in the analysis. Results: Seventy-two adults, from 2001 to 2016, were reviewed. Mean length of hospital stay was 43.0 days. A mean of 27.3 days of PN was given. Mean energy supplied by PN was 29 kcal/kg/d. Ten patients (13.8%) developed PNALD. Length of stay was significantly longer (P =.034), and duration of PN administration was significantly longer (P =.022) in patients who developed PNALD. The proportion of PN products with soybean oil–based lipids was significantly higher, and fish oil– or medium-chain triglyceride–containing combination lipids were significantly lower in the patient group with PNALD (P =.02). Multivariate logistic regression analysis showed that longer duration of days receiving PN support was an independent risk factor for PNALD (odds ratio, 1.052; P =.029). Conclusion: : The incidence of PNALD in hospitalized adult patients who received daily PN support with commercial premixed 3-in-1 products for >2 weeks was 13.8%. Longer duration of days receiving PN support was an independent risk factor for PNALD.