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- Title
Intestinal failure: the evolving demographic and patient outcomes on home parenteral nutrition.
- Authors
Brown, Sarah Kate; Davies, Natalie; Smyth, Enda; Heather, Nicky; Cole, Caroline; Keys, Simon Charles; Beattie, Robert Mark; Batra, Akshay
- Abstract
<bold>Aim: </bold>We performed this study to examine and understand the evolving demographics and changing outcomes of intestinal failure (IF) and its implications for healthcare delivery.<bold>Method: </bold>We conducted a retrospective analysis of outcome data of children on home parenteral nutrition (HPN), over a 15-year period.<bold>Results: </bold>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.<bold>Conclusion: </bold>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.
- Subjects
INTESTINAL diseases; PARENTERAL feeding; MEDICAL care; LIVER diseases; ETIOLOGY of diseases; MEDICAL rehabilitation
- Publication
Acta Paediatrica, 2018, Vol 107, Issue 12, p2207
- ISSN
0803-5253
- Publication type
journal article
- DOI
10.1111/apa.14401