Textbook outcome in short bowel syndrome

Area of Science:

• Gastroenterology and Hepatology
• Surgical Outcomes Research
• Patient Care Quality

Background:

• Textbook outcome (TO) represents an ideal care standard for medical conditions.
• Short bowel syndrome (SBS) patients face significant risks of complications and mortality.
• Determining TO incidence and predictors in SBS is crucial for improving patient management.

Purpose of the Study:

• To ascertain the incidence of Textbook Outcome (TO) in adult patients with Short Bowel Syndrome (SBS).
• To identify demographic, anatomical, and nutritional factors that predict TO achievement in SBS patients.

Main Methods:

• A cohort of 515 adult SBS patients was followed for 12 months post-discharge.
• TO was defined using eight specific outcome parameters.
• Patient demographics, intestinal anatomy, and nutritional status were analyzed for association with TO.

Main Results:

• 15% of SBS patients achieved a TO.
• Key components of TO included Parenteral Nutrition (PN) < 1 year (39%), BMI >18.5 kg/m² (89%), no stoma (59%), no readmission (56%), and survival (97%).
• Intestinal remnant length and anatomy type emerged as significant predictors of achieving TO.

Conclusions:

• A Textbook Outcome (TO) was achieved by 15% of SBS patients based on the defined criteria.
• The primary barrier to TO was the ongoing need for Parenteral Nutrition (PN).
• Intestinal length and anatomical characteristics were identified as independent predictors influencing TO attainment in SBS.