Home parenteral nutrition is the standard treatment for severe intestinal failure in the United Kingdom.
Dr Lloyd and colleagues from England reviewed long-term survival and ongoing home parenteral nutrition dependence of patients receiving home parenteral nutrition.
Medical records of patients commenced on home parenteral nutrition between 1979 and 2003 were reviewed retrospectively.
The investigative team used regression analysis to identify factors associated with poor prognosis.
Case notes of 188 patients were reviewed.
The team found that overall probability of survival was 86%, 77%, 73% and 71% at 1, 3, 5 and 10 years after starting treatment.
|Continued home parenteral nutrition dependence was 89% at 1year|
|Alimentary Pharmacology & Therapeutics|
In multivariate analysis, the team observed association between mechanism of intestinal failure and survival.
Short bowel syndrome was associated with a favourable prognosis.
The investigators observed that intestinal dysfunction, dysmotility and obstruction was associated with poorer prognoses.
The team found an association between increasing age and poor prognosis.
Increased mortality was also seen in the youngest age groups.
Only 9% of deaths were due to complications of home parenteral nutrition.
The investigators noted that continued home parenteral nutrition dependence was 89%, 87%, 84% and 84% at 1, 3, 5 and 10 years in survivors.
Dr Lloyd's team concludes, “Long-term survival of patients receiving home parenteral nutrition remains better than that reported after intestinal transplantation.”
“Mortality predominantly relates to underlying disease rather than complications of home parenteral nutrition.”