Comparing characteristics and outcomes between hospitalized adults on a pea protein or dairy/soy protein formulas: initial findings

Enteral formulas are an essential part of nutrition support to prevent or treat malnutrition and minimize hospital length of stay (LOS). Yet not all formulas are tolerated and may leave nutritional needs unmet. Unique pea protein plant-based formulas (PPPBF) are nutritionally complete and have accumulated evidence of good tolerance, but impact on health economic outcomes (HEO) is largely unknown. Aim: To examine differences in patient and clinical characteristics and HEOs of hospitalized adults using PPPBF versus dairy and/or soy protein (DSP) formulas to inform further research. Materials & methods: Retrospective comparative cohort study examined real-world data (Premier Healthcare Database) from adults (≥18 year) admitted to US hospitals who were prescribed a formula between 1 January 2020 and 30 September 2023. Patient and clinical characteristics and HEOs were compared between the PPPBF and DSP groups by unadjusted descriptive analysis. Results: Preliminary analyses were conducted on inpatients (n = 65,338 DSP; n = 243 PPPBF) from 60 US hospitals. PPPBF (versus DSP) group was younger (mean [SD] 63.6 [17.0] vs 66.7 [17.3] years; p = 0.006) and had a higher diagnosis rate for malnutrition, weight loss, food allergies, irritable bowel syndrome and/or inflammatory bowel disease on admission. Overall, formula intake was primarily oral but higher in PPPBF versus DSP (100 vs 78.3%, p < 0.001). Charlson Comorbidity Index indicated PPPBF (versus DSP) was sicker (median 4.0 vs 3.0; p < 0.001). Yet PPPBF group had shorter LOS (by ∼2 days; p < 0.001) and lower mortality rate by discharge (5.8% vs 11.5%; p = 0.005) without significant difference in 90-day readmission/outpatient visit rates after discharge (unadjusted comparisons). Conclusion: Preliminary evidence in hospitalized adults observed a shorter LOS in PPPBF users, despite higher baseline acuity and without significant difference in readmission/outpatient visit rates compared (unadjusted) to DSP users. Adjusted analyses and further research are needed.