1. Acute intestinal failure: International multicenter point-of-prevalence study
- Author
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Gregor Lansche, Marcel C. G. van de Poll, Henrik Højgaard Rasmussen, Charlene Compher, Øivind Irtun, Italo Bioni, Pilar Matía, Carlos A. Ordoñez, Steven W.M. Olde Damink, Alastair Forbes, Anna Simona Sasdelli, Zsolt Bodnár, Gintautas Kekstas, María Maíz-Jiménez, Ana Zugasti Murillo, Nizar H. Senussi, Ronan Thibault, Ramiro Manzano Nunez, Pietro Vecchiarelli, Wojciech Dabrowski, Carmina Wanden-Berghe, Hanna-Liis Lepp, Marianne S. Aloupis, Karolina Venlavicute, Stanislaw Klek, Geert J. A. Wanten, Vladislav Mihnovitš, Michael Benoit, Rosa Burgos, Loris Pironi, Kadri Lind, Ana Kunović, Zeljko Krznaric, Jon Shaffer, Ivan Pertsev, Simon M. Gabe, Francisco Pracca, Antonina Britenkova, Mette Holst, Marina Panisic-Sekeljic, Ilse Ploegmakers, Annika Reintam Blaser, Reintam Blaser, Annika, Ploegmakers, Ilse, Benoit, Michael, Holst, Mette, Rasmussen, Henrik Hojgaard, Burgos, Rosa, Forbes, Alastair, Shaffer, Jon, Gabe, Simon, Irtun, Oivind, Thibault, Ronan, Klek, Stanislaw, Olde Damink, Steven WM, van de Poll, Marcel, Panisic-Sekeljic, Marina, Wanten, Geert, Pironi, Lori, Mihnovits, Vladislav, Britenkova, Antonina, Lind, Kadri, Pertsev, Ivan, Lansche, Gregor, Sasdelli, Anna Simona, Bodnar, Zsolt, Pracca, Francisco, Bioni, Italo, Kekstas, Gintauta, Venlavicute, Karolina, Vecchiarelli, Pietro, Krznaric, Zeljko, Kunovic, Ana, Nunez, Ramiro Manzano, Ordonez, Carlos A., Lepp, Hanna-Lii, Compher, Charlene, Aloupis, Marianne, Senussi, Nizar, Murillo, Ana Zugasti, Maíz-Jiménez, María, Matia, Pilar, Wanden-Berghe, Carmina, Dabrowski, Wojciech, University of Tartu, Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht], Aalborg University [Denmark] (AAU), Vall d'Hebron University Hospital [Barcelona], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University of Bologna/Università di Bologna, Travel expenses and accommodation for AIF SIG meetings were funded by European Society for Clinical Nutrition and Metabolism (ESPEN), Luxembourg for all AIF-SIG members., Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), University of Bologna, MUMC+: MA Heelkunde (9), Surgery, and RS: NUTRIM - R2 - Liver and digestive health
- Subjects
Male ,0301 basic medicine ,Time Factors ,Epidemiology ,AIF study group ,Critical Care and Intensive Care Medicine ,law.invention ,0302 clinical medicine ,law ,Intestinal failure ,Acute care ,Prevalence ,Nutrition and Dietetic ,Hospital Mortality ,Aged, 80 and over ,Nutrition and Dietetics ,acute ,Middle Aged ,Intensive care unit ,3. Good health ,nutrition ,Acute Disease ,Female ,Adult ,medicine.medical_specialty ,Ileus ,Abdominal surgery ,030209 endocrinology & metabolism ,parenteral nutrition ,Acute ,CLASSIFICATION ,Sepsis ,Young Adult ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,medicine ,Humans ,Mortality ,Aged ,030109 nutrition & dietetics ,Nutrition & Dietetics ,business.industry ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,Parenteral nutrition ,medicine.disease ,mortality ,Intestinal Diseases ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Emergency medicine ,1111 Nutrition and Dietetics ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business - Abstract
Background & aims: Intestinal failure (IF) is defined from a requirement or intravenous supplementation due to failing capacity to absorb nutrients and fluids. Acute IF is an acute, potentially reversible form of IF. We aimed to identify the prevalence, underlying causes and outcomes of acute IF.Methods: This point-of-prevalence study included all adult patients hospitalized in acute care hospitals and receiving parenteral nutrition (PN) on a study day. The reason for PN and the mechanism of IF (if present) were documented by local investigators and reviewed by an expert panel.Results: Twenty-three hospitals (19 university, 4 regional) with a total capacity of 16,356 acute care beds and 1237 intensive care unit (ICU) beds participated in this study. On the study day, 338 patients received PN (21 patients/1000 acute care beds) and 206 (13/1000) were categorized as acute IF. The categorization of reason for PN was revised in 64 cases (18.9% of total) in consensus between the expert panel and investigators. Hospital mortality of all study patients was 21.5%; the median hospital stay was 36 days. Patients with acute IF had a hospital mortality of 20.5% and median hospital stay of 38 days (P > 0.05 for both outcomes). Disordered gut motility (e.g. ileus) was the most common mechanism of acute IF, and 71.5% of patients with acute IF had undergone abdominal surgery. Duration of PN of >= 42 days was identified as being the best cut-off predicting hospital mortality within 90 days. PN >= 42 days, age, sepsis and ICU admission were independently associated with 90-day hospital mortality.Conclusions: Around 2% of adult patients in acute care hospitals received PN, 60% of them due to acute IF. High 90-day hospital mortality and long hospital stay were observed in patients receiving PN, whereas presence of acute IF did not additionally influence these outcomes. Duration of PN was associated with increased 90-day hospital mortality. (C) 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
- Published
- 2020
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