Acute intestinal failure: International multicenter point-of-prevalence study

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. This point-of-prevale...

Full description

Saved in:

Bibliographic Details
Published in:	Clinical nutrition (Edinburgh, Scotland) Vol. 39; no. 1; pp. 151 - 158
Main Authors:	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, Loris, Mihnovits, Vladislav, Britenkova, Antonina, Lind, Kadri, Pertsev, Ivan, Lansche, Gregor, Sasdelli, Anna Simona, Bodnar, Zsolt, Pracca, Francisco, Bioni, Italo, Kekstas, Gintautas, Venlavicute, Karolina, Vecchiarelli, Pietro, Krznaric, Zeljko, Kunovic, Ana, Nunez, Ramiro Manzano, Ordonez, Carlos A., Lepp, Hanna-Liis, Compher, Charlene, Aloupis, Marianne, Senussi, Nizar, Murillo, Ana Zugasti, Maíz-Jiménez, María, Matia, Pilar, Wanden-Berghe, Carmina, Dabrowski, Wojciech
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-01-2020 Elsevier / European Society for Clinical Nutrition and Metabolism
Subjects:	Abdominal surgery Acute Acute Disease Adult Aged Aged, 80 and over Epidemiology Female Hospital Mortality Human health and pathology Humans Hépatology and Gastroenterology Intestinal Diseases - epidemiology Intestinal Diseases - therapy Intestinal failure Life Sciences Male Middle Aged Mortality Parenteral nutrition Parenteral Nutrition - methods Prevalence Santé publique et épidémiologie Time Factors Young Adult Abdominal surgery Parenteral nutrition Epidemiology Acute Mortality Intestinal failure
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	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. 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. 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. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0261-5614 1532-1983
DOI:	10.1016/j.clnu.2019.01.005