Irreversible Intestinal Failure: Prevalence and Prognostic Factors

• DOI: 10.1097/mpg.0b013e31817af979
• Publication Date: 2008-10-10T03:09:00Z
• Authors: Antonella Diamanti; Maria Sole Basso; Massimo Castro; Vincenzo Di Ciommo; Fiammetta Bracci; Francesca Ferretti; Andrea Pietrobatt...; Manuela Gambarara
• Keywords: Diarrhea; Male; Short Bowel Syndrome; Parenteral Nutrition; Time Factors; Adolescent; Infant; Prognosis; Adaptation, Physiological; Survival Analysis; 3. Good health; Intestinal Diseases; 03 medical and health sciences; 0302 clinical medicine; Cause of Death; Child, Preschool; Prevalence; Humans; Female; Child; Gastrointestinal Motility

ABSTRACTBackground and Aim:Parenteral nutrition (PN) is the primary treatment for intestinal failure, which is considered irreversible in patients who remain partially or fully dependent on PN. Causes of irreversible intestinal failure are short bowel syndrome (SBS), motility disorders (MD), and severe protracted diarrhea (SPD). The aim of this study was to report the clinical outcome in these patients in relation to the underlying disease.Patients and Methods:From January 1, 1989 to December 31, 2006, 218 intestinal failure patients were observed in our center, but only 96 (48 SBS, 39 SPD, and 9 MD) were included because they required at least 50% of their total calories as PN for not less than 3 months. In these patients, survival and complication rates were evaluated.Results:The survival rate was significantly higher in SBS patients than in the other groups (P < 0.01). SBS patients showed a higher rate of major complications, although only intestinal failure–associated liver disease was significantly higher (P < 0.001). In our series, MD was the main cause of irreversible intestinal failure.Conclusions:The potential for bowel adaptation is higher in surgical than in medical causes of intestinal failure and does not seem to be influenced by complications of intestinal failure. SBS, although worsened by the major number of complications, was not the main category contributing to intestinal failure.