Outcomes of Patients with Intestinal Failure after the Development and Implementation of a Multidisciplinary Team

Area of Science:

• Gastroenterology
• Pediatric Surgery
• Clinical Nutrition

Background:

• Intestinal failure (IF) presents complex management challenges.
• Multidisciplinary teams are increasingly recognized for optimizing patient care.
• The INtestinal Failure Advanced Nutrition Team (INFANT) was established to address these needs.

Purpose of the Study:

• To evaluate the impact of the INFANT multidisciplinary team on patient outcomes.
• To compare outcomes of patients managed by INFANT with a historical cohort.

Main Methods:

• Retrospective chart review of patients with intestinal failure over a 6-year period.
• Comparison of outcomes between patients managed by INFANT (2010-2012) and a historical cohort (2007-2009).
• Analysis included bowel length, central venous access, enteral feeding progression, and mortality.

Main Results:

• No significant differences in remaining bowel length, central venous access, or achieving full enteral feeds.
• Patients managed by INFANT required longer to achieve full enteral feeds and had a longer duration of parenteral nutrition, suggesting management of more complex cases.
• Overall mortality was lower (7.1% for INFANT vs. 14.8% historical), potentially due to an "early" intestinal failure patient population.

Conclusions:

• A multidisciplinary program, like INFANT, can improve the care of patients with intestinal failure.
• This improvement is achievable in a tertiary center without a dedicated intestinal and liver transplant program.
• The findings support the implementation of specialized teams for complex pediatric conditions.