<![CDATA[Background: Nutrition is fundamental in supporting patient care in the intensive unit. New guidelines advocate starting Enteral Nutrition (EN) and Parenteral Nutrition (PN) gradually within 48 h; nevertheless, they are still frequently initiated early and aggressively. Objective: This study aimed to assess the timing, utilization, and financial implications associated with PN therapy. Methods: One of the referral hospitals in Lampung Province was selected as the setting for this prospective cohort study, which was conducted from December 2023 to April 2024. Nutritional risk was evaluated using the mNUTRIC score, and the cost of PN was collected from secondary data. The cost analysis was limited to the cost of PN. The prices used in this study were hospital-established selling prices. Furthermore, data analysis was performed using univariate and bivariate analyses. Results: In this study, 61 patients in the intensive care unit who received nutritional support were included. Among these patients, 96.7% received PN concurrently with EN and 3.3% received PN without EN. PN was administered aggressively and remained stable within 24 h of admission for seven days. The total cost of PN amounted to IDR 299,478,581, with a mean cost of IDR 4,909,485 per patient and a median cost of IDR 2,755,309 (IQR IDR 4.580.653). The bivariate analysis found a significant association between PN cost and extended hospitalization (p < 0.001), patient mortality (p = 0.003), and elevated nutritional (p = 0.004). However, this study had a limitation in that it did not identify specific diagnoses or clinical conditions that warranted the concurrent use of PN and EN. Conclusion: In this study, we observed that accurate assessment of caloric needs, regular monitoring of nutritional intake, and judicious use of nutritional support may improve patient outcomes by reducing the duration of hospitalization and increasing the efficiency of nutritional management in patients with stroke.]]>
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