Semisolid vs Liquid Nutrients and 30‐Day Readmission in Gastrostomy Tube–Fed Patients: A Propensity‐Matched Analysis

Abstract

Background: Semisolid nutrients have been widely used to prevent complications related to enteral nutrition (EN) in Japan. However, there are few data on the effect of feeding semisolid nutrient preparations. We compared 30-day readmission rates of gastrostomy tube-fed patients who had been prescribed semisolid vs liquid nutrients on discharge. Methods: This is a retrospective observational study using a Japanese nationwide inpatient database of data entered between June 2014 and March 2018. We identified patients aged ≥18 years who had received EN through gastrostomy during hospitalization. Patients were classified as having been prescribed semisolid vs liquid EN on discharge. After one-to-one propensity score matching, all-cause 30-day readmission rates were compared between the 2 groups. Results: In total, 5331 patients were identified, including a semisolid-nutrients group (n = 2089) and a liquidnutrients group (n = 3242). Propensity score matching created 1912 pairs. The 30-day readmission rates were 15.6% and 13.9% in the semisolid-nutrients and liquid-nutrients groups, respectively. No significant difference was observed between the groups (risk difference, 1.7%; 95% CI, −0.6 to 4.0%; P = .14). Conclusion: All-cause 30-day readmission of patients receiving gastrostomy tube feeding did not differ between those prescribed semisolid vs liquid nutrients on discharge. Randomized controlled trials are needed to accurately determine the effect of semisolid nutrients on clinical outcomes.

Rheological and thermal properties of an enteral nutrition formula for nutritional support patients using a combined mixture of gelatin and maltodextrin

“…If the concentration exceeds the inversion threshold, the gel may become weakened due to the dispersion of gelatin within the continuous maltodextrin matrix as a discontinuous “filler” (Kasapis, Morris, Norton, & Clark, 1993b). Furthermore, the conducted examination of the heating process within the temperature range of 5°C–90°C indicated that the viscosity of the samples at room temperature ranged from 6540 to 9710 mPa s. According to previous reports, the viscosity ranges for this product at the same temperature, varies between 900 and 20,000 mPa s (Ichimaru & Amagai, 2015; Nagai et al, 2022; Shinozaki et al, 2021; Shizuku et al, 2011; Tabei et al, 2018). Hence, the present study has developed a semisolid product with a moderate viscosity, which has been previously mentioned as a potential candidate for utilization as an EN formula.…”

“…The adjustment of viscosity to an optimal level is of utmost importance for the clinical and practical efficacy of an EN formula (Wakita et al, 2012). Thickened and semisolid enteral nutrient products with increased viscosity are commonly favored over liquid formulas for administration through large‐diameter gastrostomy tubes (Ichimaru & Amagai, 2015; Shinozaki et al, 2021). This preference is associated with a reduction in diarrhea and GER in patients who require intubation (Ellinger, 2015; Kokura et al, 2020; Wakita et al, 2012; Yoon & Wong, 2018).…”