{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T03:59:26Z","timestamp":1779249566203,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T00:00:00Z","timestamp":1620950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Human Nutrition Diet"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Emergency general surgical patients are inherently at high risk of malnutrition. Early decision\u2010making with implementation is fundamental to patient recovery. For many patients, parenteral nutrition (PN) is the only feeding option available. The present study assessed the timing and outcomes of this decision\u2010making process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A sample of at least 10 consecutive adult patients admitted as a general surgical emergency to eight UK hospitals over 1\u00a0year who had received PN was identified. Patient demographics, basic descriptors and nutritional data were captured. Process measures regarding dates decisions were made or activities completed were extracted from records, as were outcome measures including PN complications. Six time frames examining the process of PN delivery were analysed. Associations between categorical and binary variables were investigated with a chi\u2010squared test with significance determined as <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 125 patients were included. Intestinal obstruction was the most common diagnosis with 59% of all patients deemed high risk on nutritional assessment at admission. Median time to decision for PN was 5\u00a0days following admission (<jats:italic>n<\/jats:italic>\u00a0=\u00a0122, interquartile range\u00a0=\u00a07). Patients received PN for a mean of 11\u00a0days. Eighty\u2010five percent of patients developed a complication, with a phosphate abnormality being the most commonly reported (54%). Only altered blood glucose levels appeared to correlate with a delay in starting PN (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study shows there are delays in the decision to use PN in the acutely ill surgical patient. Once initiated, the pathway is relatively short. There are high rates of electrolyte abnormalities in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jhn.12902","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T09:30:26Z","timestamp":1617874226000},"page":"5-13","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Parenteral nutrition in emergency surgery: A multicentre cross\u2010sectional study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4321-5613","authenticated-orcid":false,"given":"Daniel","family":"Ashmore","sequence":"first","affiliation":[{"name":"Department of General Surgery Barnsley Hospital NHS Foundation Trust Barnsley UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Oncology and Metabolism The Medical School University of Sheffield Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"The Nutrition in Emergency Surgery (NEmS) collaborative","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,14]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"The Royal College of Surgeons of England.Emergency Surgery standards for unscheduled surgical care guidance for providers commissioners and service planners.2011.https:\/\/www.rcseng.ac.uk\/library\u2010and\u2010publications\/rcs\u2010publications\/docs\/emergency\u2010surgery\u2010standards\u2010for\u2010unscheduled\u2010care\/. Accessed 14 Jul 2020."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9208"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc4357"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61148-9"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000517"},{"key":"e_1_2_12_7_1","first-page":"3524","article-title":"Impact of patients nutritional status on major surgery outcome","volume":"22","author":"Mignini EV","year":"2018","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_12_8_1","volume-title":"NICE Clinical Guidline 32. Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition","author":"National Institute for Health and Care Excellence","year":"2017"},{"key":"e_1_2_12_9_1","unstructured":"Malnutrition Advisory Group.The \u201cMUST\u201d Report. Nutritional screening of adults: a multidisciplinary responsibility.2003. HYPERLINK \"sps:urlprefix::https\"https:\/\/www.bapen.org.uk\/pdfs\/must\/must\u2010report.pdf. Accessed 14 Jul 2020."},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302514a.74"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/fg.2009.000224"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13321"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115621863"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2009.04.002"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2017.02.013"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2006.01.015"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607116676592"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1054\/clnu.2000.0103"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2009.03.015"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1067\/mic.2001.111536"},{"key":"e_1_2_12_21_1","volume-title":"A mixed bag: An enquiry into the care of hospital patients receiving parenteral nutrition","author":"Stewart J","year":"2010"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2005.07.005"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533613507455"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8071065"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1985.37"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/NAN.0b013e31823b98ef"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14016"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-029235"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs5.50136"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_12_32_1","unstructured":"JukesA WalesA ScreeningN.Nutrition Screening \u2010 working towards an All Wales approach.2018.https:\/\/www.bapen.org.uk\/pdfs\/conference\u2010presentations\/2018\/tues\/symposium\u20103\/Amelia\u2010Jukes.pdf. Accessed 14 Jul 2020."},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1749-7922-6-5"},{"key":"e_1_2_12_34_1","first-page":"3","volume-title":"Refeeding syndrome: Identification of those at risk\u00a0\u2013\u00a0Decision Tree","author":"BAPEN","year":"2012"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs5.50233"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.12968\/jprp.2019.1.11.556"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/ejhpharm-2016-000949"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.3628"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12345"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1996.01430220037007"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-002173"},{"key":"e_1_2_12_42_1","first-page":"365","article-title":"Severe hypophosphatemia in hospitalized patients","volume":"16","author":"Camp M","year":"1990","journal-title":"Miner Electrolyte Metab"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607116673186"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2011.239301.3"}],"container-title":["Journal of Human Nutrition and Dietetics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jhn.12902","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jhn.12902","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jhn.12902","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T09:03:01Z","timestamp":1693213381000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jhn.12902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,14]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1111\/jhn.12902"],"URL":"https:\/\/doi.org\/10.1111\/jhn.12902","archive":["Portico"],"relation":{},"ISSN":["0952-3871","1365-277X"],"issn-type":[{"value":"0952-3871","type":"print"},{"value":"1365-277X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,14]]},"assertion":[{"value":"2020-09-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}