Intestinal failure: the evolving demographic and patient outcomes on home parenteral nutrition

Acta Paediatrica
Sarah Kate BrownAkshay Batra

Abstract

We performed this study to examine and understand the evolving demographics and changing outcomes of intestinal failure (IF) and its implications for healthcare delivery. We conducted a retrospective analysis of outcome data of children on home parenteral nutrition (HPN), over a 15-year period. A total of 31 patients received HPN: 15 for short bowel syndrome (SBS), eight neuromuscular disease (NMD) and eight for other causes. The HPN prevalence increased from 1.54 per million children in 2000 to 21.5 in 2016. The outcomes over last 5 years were better than those of previous 10 years. The rate of catheter-related bloodstream infection (CRBSI) had fallen from 4 to 1.3 and IF liver disease (IFALD) from 20% to 7.7%. The aetiology changed over years from SBS being the main cause to NMD contributing 43% to the total in 2016. This was especially relevant as NMD was associated with greater numbers of IFALD (38% vs 6.7%), CRBSI (1.51 vs 0.64/1000 PN days) and mortality. The outcome of long-term parenteral nutrition (PN) has improved. The increasing number of patients with NMD, coupled with their higher burden of care, results in an increasing health care burden, and the planning of intestinal rehabilitation services needs to reflect this.

References

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Sep 4, 2017·Archives of Disease in Childhood. Fetal and Neonatal Edition·Akshay BatraRobert Mark Beattie

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Citations

Dec 5, 2018·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Titilola M Afolabi, Kathleen A Fairman
May 15, 2020·Journal of Pediatric Gastroenterology and Nutrition·Mary HalseyAkshay Batra
Jul 21, 2020·Nutrición hospitalaria·Marta Mejías TruebaJosé Luis Pereira Cunill
Jul 28, 2020·Journal of Pediatric Surgery·Katherine I PortelliJames C Y Dunn
Nov 17, 2020·Journal of Paediatrics and Child Health·Jason Y K YapJulie E Bines
Apr 22, 2021·JPEN. Journal of Parenteral and Enteral Nutrition·Roxana FatemizadehMuralidhar H Premkumar
Jun 1, 2021·American Journal of Surgery·John S GrahamColin A Martin

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