In-hospital Outcomes Between Total Parenteral Nutrition and Enteral Feeding in Esophageal and Gastric Cancer: A Nationwide Analysis.

[BACKGROUND/AIM] Patients with gastric and esophageal cancer (GEC) often experience significant dysphagia, leading to malnutrition and weight loss. Nutritional support strategies, such as total parenteral nutrition (TPN) and gastrostomy or jejunostomy (G/J) tube placement, are commonly used in managing these patients. However, their impact on in-hospital outcomes remains uncertain. The aim of this study was to compare in-hospital outcomes between patients with GEC receiving TPN and those undergoing G/J tube placement.

[PATIENTS AND METHODS] This retrospective cohort study utilized the National Inpatient Sample (NIS) from 2016 to 2020. It included all hospitalizations of adult patients with GEC who received either TPN or G/J tube placement. A total of 65,575 hospitalizations were analyzed, with 12,535 (19.1%) receiving TPN and 53,040 (80.9%) undergoing G/J tube placement. Logistic regression analysis was used to assess the odds of various in-hospital outcomes.

[RESULTS] Patients who underwent G/J tube placement had significantly lower odds of mortality [adjusted odds ratio (aOR)=0.47, 95% confidence interval (CI)=0.44-0.51], deep vein thrombosis (DVT) (aOR=0.54, 95%CI=0.48-0.61), pulmonary embolism (PE) (aOR=0.51, 95%CI=0.46-0.57), acute liver failure (aOR=0.66, 95%CI=0.51-0.84), acute kidney injury (aOR=0.64, 95%CI=0.60-0.67), and sepsis (aOR=0.46, 95%CI=0.43-0.49) compared to those who received TPN.

[CONCLUSION] Enteral feeding through G/J tube placement is associated with more favorable in-hospital outcomes, including lower odds of mortality and other complications, compared to TPN in patients with GEC.