Abstract Background This study aimed to investigate the associations between parenteral energy/amino acid doses and clinical outcomes in patients who were fasting after gastroenterological cancer surgery. Methods Patients who were fasting for ≥ 7 days after gastroenterological cancer surgery between 2011 and 2022 were identified in a Japanese medical claims database. The associations between parenteral energy/amino acid doses which are supplied to patients via the peripheral or central vein and clinical adverse events were investigated. Low- ( 0.8 g/kg/day) and high- (≥ 0.8 g/kg/day) amino acid dose groups were compared using propensity score matching (PSM). The primary outcome was clinical adverse events, and secondary outcomes were in-hospital mortality, postoperative complications, decline in activities of daily living, rehospitalization, length of hospital stay, and hospitalization costs. Results Of 18,294 eligible patients, no association was found between clinical adverse events and energy doses (Wald test, P = 0.065). Patients who had high-amino acid doses were significantly associated with lower clinical adverse events than patients who had low-amino acid doses (Wald test, P = 0.002). After PSM, 2,585 pairs were formed. Clinical adverse events (42.1% vs 45.1%; odds ratio, 0.88; 95% confidence interval CI, 0.79–0.99), in-hospital mortality (4.2% vs 5.4%; odds ratio, 0.77; 95% CI, 0.59–0.99), and hospitalization costs (19,788 vs 20,606 USD; regression coefficient, −1,538; 95% CI, −2,250 to −833) were significantly lower in the high-amino acid group. There were no significant differences in other outcomes. Conclusions Parenteral amino acid dosing may play an important role in improving clinical outcomes in patients after gastroenterological cancer surgery, particularly in those who are fasting for 7 days or longer.
Kawaguchi et al. (Tue,) studied this question.