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Intestinal failure: the evolving demographic and patient outcomes on home parenteral nutrition
Author(s) -
Brown Sarah Kate,
Davies Natalie,
Smyth Enda,
Heather Nicky,
Cole Caroline,
Keys Simon Charles,
Beattie Robert Mark,
Batra Akshay
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14401
Subject(s) - medicine , parenteral nutrition , short bowel syndrome , intestinal failure , demographics , etiology , pediatrics , retrospective cohort study , intensive care medicine , demography , sociology
Aim We performed this study to examine and understand the evolving demographics and changing outcomes of intestinal failure (IF) and its implications for healthcare delivery. Method We conducted a retrospective analysis of outcome data of children on home parenteral nutrition ( HPN ), over a 15‐year period. Results 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. Conclusion 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.