ORCID

0000-0002-8991-1737 (Pant)

Document Type

Article

Publication Date

2025

DOI

10.1002/ncp.70034

Publication Title

Nutrition in Clinical Practice

Volume

Advance online publication

Pages

8 pp.

Abstract

Background

Home parenteral nutrition (HPN) patients often have multiple comorbidities. A validated multimorbidity index (MMI) could help determine resource needs and risks with HPN. We evaluated MMI scoring to determine if it predicted HPN resource use and outcomes.

Methods

We performed a secondary analysis of 60 HPN patients from a previous study based on Cumulative Illness Rating Scale (CIRS) scoring. We examined three variables: PN formula changes, hospitalizations, and hospital length of stay (LOS). Density plots were produced to select a CIRS score cutoff value. Spearman correlations among the three variables of interest were computed. The data were then subjected to Wilcoxon rank sum tests and negative binomial regression models to determine if the measured variables differed significantly between the groups.

Results

In 60 HPN patients, CIRS scores ranged from 9 to 25 with a mean ± SD of 17.0 ± 3.85. Patients with CIRS scores ≥ 17 had higher rates of the three variables than those with CIRS scores < 17 (PN formula changes = 367 vs 297, hospitalizations = 19 vs 12, and total hospital LOS days = 122 vs 100). Although these raw data did not differ significantly, negative binomial regression analysis indicated that the interaction of total hospital LOS and PN formula changes was significantly higher in patients with a CIRS score ≥ 17 than a CIRS score < 17.

Conclusion

CIRS data from HPN patients showed a trend wherein higher multimorbidity scores were associated with PN changes and LOS. This approach requires further study and validation.

Rights

© 2025 The Authors.

This is an open access article under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Data Availability

Article states: "Data described in the manuscript will be made available upon request to the first author, pending application and approval."

Original Publication Citation

Rothkopf, M. M., Pant, M., Rothkopf, Z., Brown, R., Haselhorst, J., Stevenson, D. L., Depalma, A., & Saracco, M. (2025). Pilot study on the use of a multimorbidity index in patients receiving home parenteral nutrition. Nutrition in Clinical Practice. Advance online publication. https://doi.org/10.1002/ncp.70034

ncp70034-sup-0001-cirs_calculation_worksheet_example_8-6-25.pdf (19 kB)
CIRS Calculation Worksheet Example 8-6-25.

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