Association of Nutritional Support with Survival Time in Hospitalized Older Patients with Dysphagia: A Retrospective Study

Manabe et al discuss their study which aims to clarify the effects of artificial nutritional support route on survival time of older terminal patients with dysphagia. Their study found that the most frequent cause of death in the parenteral nutrition (PN) group was heart failure, whereas it was pneumonia in the enteral nutrition (EN) and EN/PN groups, which is the most common cause of death in older adults with dysphagia. According to guidelines for the nutritional support of critically ill adult and pediatric patients, early EN initiation reduces the incidences of infection and mortality. The intestinal tract plays an important role in immunity, as well as digestion and absorption, and it maybe that EN prolongs survival, even in the terminal stage of an illness. They conclude that the use of PN use was associated with higher risks of mortality, compared with EN or EN/PN, but residual confounding cannot be excluded.