Intestinal failure: the evolving demographic and patient outcomes on home parenteral nutrition
Intestinal failure: the evolving demographic and patient outcomes on home parenteral nutrition
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DOI：
10.1111/apa.14401
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发表时间：
2018-12-01
期刊：
影响因子：
3.8
通讯作者：
Batra, Akshay
中科院分区：
文献类型：
--
作者：
Brown, Sarah Kate;Davies, Natalie;Batra, Akshay
目的我们进行这项研究，以检查和了解不断演变的人口统计学和不断变化的结果，肠衰竭(IF)及其对医疗保健提供的影响。方法对15年来儿童家庭肠外营养(HPN)的结局资料进行回顾性分析。共有31名患者接受了HPN治疗：15名患者为短肠综合征(SBS)，8名患者为神经肌肉疾病(NMD)，8名患者为其他原因。HPN患病率从2000年的每百万名儿童1.54人增加到2016年的21.5人。过去5年的结果比前10年的结果要好。导管相关性血流感染(CRBSI)的发生率从4%下降到1.3，肝病(IFALD)的发生率从20%下降到7.7%。多年来，病因发生了变化，从SBS成为主要原因，到2016年NMD占总数的43%。这一点尤其相关，因为NMD与IFALD(38%比6.7%)、CRBSI(1.51比0.64/1000 PN天)和死亡率相关。结论长期肠外营养(PN)的效果明显改善。NMD患者数量的增加，加上他们更高的护理负担，导致卫生保健负担增加，肠道康复服务的规划需要反映这一点。
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 Results 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. 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.