Clinical Outcomes on Home Parenteral Support for Patients with Benign Chronic Intestinal Failure: Systematic Review...

Background/Objectives: Chronic intestinal failure (IF) necessitating home parenteral support (HPS) represents an end-stage condition for many gastrointestinal diseases. While long-term outcomes have been reported in HPS-dependent patients, there are limited generalisable data on survival and nutritional autonomy rates in large contemporary cohorts. The primary objective of this study was to examine the evidence on mortality and nutritional autonomy rates for HPS published to 2025. Methods: This is a systematic review and meta-analysis (PROSPERO Registration number: CRD42025645325). A database search was conducted up to 3 February 2025. Studies assessing survival and nutritional autonomy in adults with benign chronic IF receiving HPS were included. For clinical outcomes, crude proportions were calculated and a meta-analysis was performed to calculate the proportion affected per year of follow-up, with survival probabilities additionally presented on Kaplan-Meier curves. Results: Overall, 3411 records were screened and 57 studies were included. The overall mortality was 8.0% per year of follow-up (95% CI 6.0 to 10.0%), or 33.5% over a mean of 49.02 months. The summary of survival curves estimated the pooled five- and ten-year survival rates from HPS initiation as 68.71% and 52.46%, respectively. Nutritional autonomy was achieved in 35.3% of patients, at a rate of 10.0% per year of follow-up (95% CI 7.0% to 14.0%). Age, gastrointestinal anatomy, and underlying disease leading to IF were identified as potential factors associated with mortality and nutritional autonomy. Conclusions: This is the first systematic review and meta-analysis summarising the current literature on survival and nutritional autonomy in adults with chronic IF. These findings increase our understanding of this complex condition, providing baseline data to support clinical decision-making and patient counselling.