Survival and nutritional dependence on home parenteral nutrition: Three decades of experience from a single referral centre.

摘要: Summary Background Home parenteral nutrition (HPN) is the mainstay of treatment for patients with Type 3 intestinal failure (IF), however long term data on mortality and nutritional outcomes are limited. Objectives To assess long-term survival requirements ongoing HPN in receiving at a UK national referral centre failure. Methods Patients IF who received more than 3 months at this Intestinal Failure Unit between 1978 2011 had their clinical records reviewed. SPSS 20 was utilised to perform Cox regression analysis generate Kaplan Meier curves, aim identifying factors associated death continued need HPN. Results Case notes from 545 were Overall (OS) without malignancy commencement 93%, 71%, 59% 28% 1, 5, 10 years after starting treatment. Crohn's disease, mesenteric ischaemia chronic pseudo-obstruction better OS scleroderma radiation enteritis multivariate analysis. Older age onset poor OS, while shorter small bowel length or central line sepsis not. 15% (25/170) deaths due complications (central sepsis = 10, IF-associated liver disease = 15). Continued dependence survivors 83%, 63%, 53% 15 years, respectively. Among 153 achieved independence HPN, 77 (50.3%) did so surgical reconstruction alimentary tract (HPN duration mean 19 months, range 3–126 months). 76 (49.7%) weaned undergoing reconstruction. Conclusion This largest reported set will inform indications, benefits risks disease specific groups. A significant proportion autonomy intervention.