Survival Outcomes of Pediatric Intestinal Failure Patients: Analysis of Factors Contributing to Improved Survival Over the Past Two Decades

Hess, Rebecca A.; Welch, Kathleen B.; Brown, Pamela Allen; Teitelbaum, Daniel H.

doi:10.1016/j.jss.2011.03.037

Cited by 118 publications

(83 citation statements)

References 27 publications

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“…The prognosis is known to be the best for SBS, worse for motility disorders and the worst for non-gastrointestinal primary diagnoses [2,5,7,36]. The same tendency was observed in our cohort.…”

Section: Discussionsupporting

confidence: 85%

“…The main indication for HPN in our cohort, as well as in other paediatric series reported [2,5,22,35,36], was gastrointestinal disease, with the subgroup of SBS patients (mainly following necrotizing enterocolitis) accounting for a majority of cases. …”

Section: Discussionsupporting

confidence: 63%

“…The outcome in children with SBS - 92.7% survived and 68.3% were weaned - is not different from the results of others: survival 93%, weaning 61% [2]; survival 72.5%, weaning 63.8% [35]; weaning 67.5% [36]; survival 100%, weaning 73% [37]. In our series, children with preserved ICV or colon had a significantly greater probability of favourable outcome, while the influence of the remaining intestine length failed to reach significance, probably due to small numbers [38].…”

Section: Discussionmentioning

confidence: 84%

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Paediatric Home Parenteral Nutrition in the Czech Republic and Its Development: Multicentre Retrospective Study 1995-2011

Stýblová¹,

Kalousová

Adamcová³

et al. 2017

Ann Nutr Metab

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Background: Treatment quality and outcomes of paediatric home parenteral nutrition (HPN) program during its development in the Czech Republic. Methods: A retrospective study of patients receiving HPN from May 1995 till June 2011. Results: Sixty-six patients were treated in 8 centres. In 48 patients, long-term PN began in the first year of life and in 35 of them in the first month. Sixty children had gastrointestinal and 6 had non-gastrointestinal disease. In a majority of the patients, the Broviac catheter was used. Thirty-two (48.5%) patients were weaned from PN after 1-117 months, 21 (32.8%) continued on HPN after 7-183 months, and 13 (19.7%) patients died, all on PN. The mortality in patients with primary gastrointestinal disease was significantly lower than in patients with non-gastrointestinal disease. Thirty-one paediatric patients were receiving HPN for 14,480 catheter days in 2009-2010. Fourteen patients had 23 Catheter Related Blood Stream Infections (CRBSI) episodes. The incidence of CRBSI in 2009-2010 was 1.58/1,000 catheter days. Conclusion: Submitted data showed that even in the absence of expert centres, patient care may achieve results comparable to countries with well-developed HPN program. A majority of Czech HPN patients are at present treated in specialized centres, following the most desirable pattern of care.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 84%

See 1 more Smart Citation

Paediatric Home Parenteral Nutrition in the Czech Republic and Its Development: Multicentre Retrospective Study 1995-2011

Stýblová¹,

Kalousová

Adamcová³

et al. 2017

Ann Nutr Metab

View full text Add to dashboard Cite

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“…Additionally, the social and financial burden for patients on prolonged PN is substantial, even with primarily outpatient management (3). Limiting the duration of PN by promoting enteral autonomy has been shown to decrease complications (4) and improve survival for pediatric IF patients (5). …”

Section: Definitionsmentioning

confidence: 99%

Enteral Nutrition in the Management of Pediatric Intestinal Failure

Gosselin

Duggan

2014

The Journal of Pediatrics

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“…compared children with onset of IF between 1990-1994 with those whose onset was between 2005-2009 and reported that mortality fell during those time intervals from 29.4% to 6.7%, respectively. 10 Months and often years of PN are necessary before enteral autonomy (EA) is established. 4 For children unable to achieve EA or who develop life-threatening complications associated with IF and its management, intestinal transplantation (ITx) can be life-saving.…”

Section: Introductionmentioning

confidence: 99%

Race Affects Outcome Among Infants With Intestinal Failure

Squires

Balint

Horslen

et al. 2014

J. pediatr. gastroenterol. nutr.

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Objective Intestinal failure is a rare, devastating condition associated with significant morbidity and mortality. We sought to determine if ethnic and racial differences were associated with patient survival and likelihood of receiving an intestinal transplant in a contemporary cohort of children with intestinal failure. Methods This was an analysis of a multicenter cohort study with data collected from chart review conducted by the Pediatric Intestinal Consortium (PIFCon). Entry criteria included infants < 12 mo receiving parenteral nutrition (PN) for > 60 continuous days and followed for at least 2 years. Outcomes included death and intestinal transplant (ITx). Race and ethnicity were recorded as they were in the medical record. For purposes of statistical comparisons and regression modeling, categories of race were consolidated into “white” and “non-white” children. Results Of 272 subjects enrolled, 204 white and 46 non-white children were available for analysis. The 48 month cumulative incidence probability (CIP) of death without ITx was 0.40 for non-white and 0.16 for white children (p<0.001); the CIP of ITx was 0.07 for non-white vs 0.31 for white children (p=0.003). The associations between race and outcomes remained after accounting for low-birth weight, diagnosis, and being seen at a transplant center. Conclusion Race is associated with death and receiving an ITx in a large cohort of children with intestinal failure. This study highlights the need to investigate reasons for this apparent racial disparity in outcome among children with intestinal failure.

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Survival Outcomes of Pediatric Intestinal Failure Patients: Analysis of Factors Contributing to Improved Survival Over the Past Two Decades

Cited by 118 publications

References 27 publications

Paediatric Home Parenteral Nutrition in the Czech Republic and Its Development: Multicentre Retrospective Study 1995-2011

Paediatric Home Parenteral Nutrition in the Czech Republic and Its Development: Multicentre Retrospective Study 1995-2011

Enteral Nutrition in the Management of Pediatric Intestinal Failure

Race Affects Outcome Among Infants With Intestinal Failure

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