Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey
Loris Pironi, Ezra Steiger, Francisca Joly, Palle B Jeppesen, Geert Wanten, Anna S Sasdelli, Cecile Chambrier, Umberto Aimasso, Manpreet S Mundi, Kinga Szczepanek, Amelia Jukes, Miriam Theilla, Marek Kunecki, Joanne Daniels, Mireille Serlie, Florian Poullenot, Sheldon C Cooper, Henrik H Rasmussen, Charlene Compher, David Seguy, Adriana Crivelli, Lidia Santarpia, Francesco W Guglielmi, Nada Rotovnik Kozjek, Stéphane M Schneider, Lars Ellegard, Ronan Thibault, Przemysław Matras, Konrad Matysiak, Andrè Van Gossum, Alastair Forbes, Nicola Wyer, Marina Taus, Nuria M Virgili, Margie O'Callaghan, Brooke Chapman, Emma Osland, Cristina Cuerda, Gábor Udvarhelyi, Lynn Jones, Andre D Won Lee, Luisa Masconale, Paolo Orlandoni, Corrado Spaggiari, Marta Bueno Díez, Maryana Doitchinova-Simeonova, Aurora E Serralde-Zúñiga, Gabriel Olveira, Zeljko Krznaric, Laszlo Czako, Gintautas Kekstas, Alejandro Sanz-Paris, Mª Estrella Petrina Jáuregui, Ana Zugasti Murillo, Eszter Schafer, Jann Arends, José P Suárez-Llanos, Nader N Youssef, Giorgia Brillanti, Elena Nardi, Simon Lal, Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN, European Society for Clinical Nutrition and Metabolism, Adriana N Crivelli, Hector Solar Muñiz, Brooke R Chapman, Lynn Jones, Margie O'Callaghan, Emma Osland, Ruth Hodgson, Siobhan Wallin, Kay Lasenby, Andre Van Gossum, Andre Dong Won Lee, Maryana Doitchinova-Simeonova, Zeljko Krznaric, Henrik Højgaard Rasmussen, Chrisoffer Brandt, Palle B Jeppesen, Cecile Chambrier, Francisca Joly, Vanessa Boehm, Julie Bataille, Lore Billiauws, Florian Poullenot, Stéphane M Schneider, David Seguy, Ronan Thibault, Jann Arends, Laszlo Czako, Tomas Molnar, Mihaly Zsilak-Urban, Ferenc Izbéki, Peter Sahin, Gábor Udvarhelyi, Eszter Schafer, Miriam Theilla, Anna Simona Sasdelli, Giorgia Brillanti, Elena Nardi, Loris Pironi, Umberto Aimasso, Merlo F Dario, Valentino Bertasi, Luisa Masconale, Francesco W Guglielmi, Nunzia Regano, Paolo Orlandoni, Santarpia Lidia, Lucia Alfonsi, Corrado Spaggiari, Marina Taus, Debora Busni, Gintautas Kekstas, Aurora E Serralde-Zúñiga, Lyn Gillanders, Marek Kunecki, Przemysław Matras, Konrad Matysiak, Kinga Szczepanek, Anna Zmarzly, Nada Rotovnik Kozjek, Marta Bueno, Cristina Cuerda, Carmen Garde, Nuria M Virgili, Gabriel Olveira, Ma Estrella Petrina Jáuregui, Alejandro Sanz-Paris, José P Suárez-Llanos, Ana Zugasti Murillo, Lars Ellegard, Mireille Serlie, Cora Jonker, Geert Wanten, Sheldon C Cooper, Joanne Daniels, Simona Di Caro, Niamh Keane, Pinal Patel, Alastair Forbes, Sarah-Jane Nelson Hughes, Amelia Jukes, Rachel Lloyd, Simon Lal, Arun Abraham, Gerda Garside, Michael Taylor, Jian Wu, Trevor Smith, Charlotte Pither, Michael Stroud, Nicola Wyer, Reena Parmar, Nicola Burch, Sarah Zeraschi, Charlene Compher, Manpreet Mundi, Denise Jezerski, Ezra Steiger, Elena Nardi, Giorgia Brillanti, Loris Pironi, Ezra Steiger, Francisca Joly, Palle B Jeppesen, Geert Wanten, Anna S Sasdelli, Cecile Chambrier, Umberto Aimasso, Manpreet S Mundi, Kinga Szczepanek, Amelia Jukes, Miriam Theilla, Marek Kunecki, Joanne Daniels, Mireille Serlie, Florian Poullenot, Sheldon C Cooper, Henrik H Rasmussen, Charlene Compher, David Seguy, Adriana Crivelli, Lidia Santarpia, Francesco W Guglielmi, Nada Rotovnik Kozjek, Stéphane M Schneider, Lars Ellegard, Ronan Thibault, Przemysław Matras, Konrad Matysiak, Andrè Van Gossum, Alastair Forbes, Nicola Wyer, Marina Taus, Nuria M Virgili, Margie O'Callaghan, Brooke Chapman, Emma Osland, Cristina Cuerda, Gábor Udvarhelyi, Lynn Jones, Andre D Won Lee, Luisa Masconale, Paolo Orlandoni, Corrado Spaggiari, Marta Bueno Díez, Maryana Doitchinova-Simeonova, Aurora E Serralde-Zúñiga, Gabriel Olveira, Zeljko Krznaric, Laszlo Czako, Gintautas Kekstas, Alejandro Sanz-Paris, Mª Estrella Petrina Jáuregui, Ana Zugasti Murillo, Eszter Schafer, Jann Arends, José P Suárez-Llanos, Nader N Youssef, Giorgia Brillanti, Elena Nardi, Simon Lal, Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN, European Society for Clinical Nutrition and Metabolism, Adriana N Crivelli, Hector Solar Muñiz, Brooke R Chapman, Lynn Jones, Margie O'Callaghan, Emma Osland, Ruth Hodgson, Siobhan Wallin, Kay Lasenby, Andre Van Gossum, Andre Dong Won Lee, Maryana Doitchinova-Simeonova, Zeljko Krznaric, Henrik Højgaard Rasmussen, Chrisoffer Brandt, Palle B Jeppesen, Cecile Chambrier, Francisca Joly, Vanessa Boehm, Julie Bataille, Lore Billiauws, Florian Poullenot, Stéphane M Schneider, David Seguy, Ronan Thibault, Jann Arends, Laszlo Czako, Tomas Molnar, Mihaly Zsilak-Urban, Ferenc Izbéki, Peter Sahin, Gábor Udvarhelyi, Eszter Schafer, Miriam Theilla, Anna Simona Sasdelli, Giorgia Brillanti, Elena Nardi, Loris Pironi, Umberto Aimasso, Merlo F Dario, Valentino Bertasi, Luisa Masconale, Francesco W Guglielmi, Nunzia Regano, Paolo Orlandoni, Santarpia Lidia, Lucia Alfonsi, Corrado Spaggiari, Marina Taus, Debora Busni, Gintautas Kekstas, Aurora E Serralde-Zúñiga, Lyn Gillanders, Marek Kunecki, Przemysław Matras, Konrad Matysiak, Kinga Szczepanek, Anna Zmarzly, Nada Rotovnik Kozjek, Marta Bueno, Cristina Cuerda, Carmen Garde, Nuria M Virgili, Gabriel Olveira, Ma Estrella Petrina Jáuregui, Alejandro Sanz-Paris, José P Suárez-Llanos, Ana Zugasti Murillo, Lars Ellegard, Mireille Serlie, Cora Jonker, Geert Wanten, Sheldon C Cooper, Joanne Daniels, Simona Di Caro, Niamh Keane, Pinal Patel, Alastair Forbes, Sarah-Jane Nelson Hughes, Amelia Jukes, Rachel Lloyd, Simon Lal, Arun Abraham, Gerda Garside, Michael Taylor, Jian Wu, Trevor Smith, Charlotte Pither, Michael Stroud, Nicola Wyer, Reena Parmar, Nicola Burch, Sarah Zeraschi, Charlene Compher, Manpreet Mundi, Denise Jezerski, Ezra Steiger, Elena Nardi, Giorgia Brillanti
Abstract
Background and aims: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries.
Methods: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as <1, 1-2, 2-3 and >3 L/day.
Results: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland.
Conclusions: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.
Keywords: Epidemiology; Home parenteral nutrition; Intestinal failure; Intravenous supplementation; Short bowel syndrome.
Conflict of interest statement
Declaration of competing interest None declared.
Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
Source: PubMed