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Irreversible intestinal failure: prevalence and prognostic factors
Antonella Diamanti1, Maria Sole Basso, Massimo Castro
1Gastroenterology and Nutrition Unit, Bambino Gesù Children's Hospital, Rome, Italy.
Journal of Pediatric Gastroenterology and Nutrition
|October 15, 2008
Summary
Patients with short bowel syndrome (SBS) have higher survival rates despite more complications. Motility disorders (MD) were the primary cause of irreversible intestinal failure in this study.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Surgical Science
Background:
- Parenteral nutrition (PN) is crucial for managing irreversible intestinal failure.
- Causes include short bowel syndrome (SBS), motility disorders (MD), and severe protracted diarrhea (SPD).
Purpose of the Study:
- To analyze clinical outcomes in patients with irreversible intestinal failure.
- To correlate outcomes with underlying diseases: SBS, MD, and SPD.
Main Methods:
- Retrospective analysis of 96 intestinal failure patients (1989-2006).
- Inclusion criteria: ≥50% PN calories for ≥3 months.
- Evaluation of survival and complication rates based on underlying disease.
Main Results:
- Short bowel syndrome (SBS) patients exhibited significantly higher survival rates (P < 0.01).
- SBS patients had more major complications, notably intestinal failure-associated liver disease (P < 0.001).
- Motility disorders (MD) emerged as the leading cause of irreversible intestinal failure in this cohort.
Conclusions:
- Bowel adaptation potential is greater for surgical than medical causes of intestinal failure.
- Complications did not appear to significantly impact bowel adaptation.
- Despite higher complication rates, SBS was not the predominant cause of irreversible intestinal failure.
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