A multicenter study on enteral autonomy outcome of pediatric intestinal failure patients from a middle-income country.

• Tác giả: Marina R Adami, Maria Fernanda C de Camargo, Marilia R Ceza, Leticia Feldens, Mariana J B M Fonseca, Camila P Genzani, Liege L Godoy, Helena A S Goldani, Catiana M Gritti, Eduardo F Hatanaka, Carlos O Kieling, Paulo C Koch Nogueira, Heitor P Leite, Roberta L Longo, Joao Seda Neto, Daltro L A Nunes, Estela C Pavanelli, Simone M R M Perentel, Natalia C Person, Berenice L Santos, Keilla M C B Uchoa, Rodrigo Vincenzi
• Ngôn ngữ: eng
• Ký hiệu phân loại: 809.008 History and description with respect to kinds of persons
• Thông tin xuất bản: England : Clinical nutrition ESPEN , 2025
• Bộ sưu tập: NCBI
• ID: 716326

Tóm tắt

 BACKGROUND & AIMS: To identify predictors of enteral autonomy and survival in pediatric intestinal failure patients followed up at three pediatric intestinal rehabilitation centers from a middle-income country. METHODS: This retrospective multicenter cohort study evaluated patients with intestinal failure from three high-volume intestinal rehabilitation centers on long-term parenteral nutrition between 2014 and 2023. The primary outcome was status at the end of the follow-up: parenteral nutrition dependence, enteral autonomy, transplantation, or death. Secondary outcomes were complications resulting from treatment and current parenteral nutrition dependency index. Competing risk analysis, Cox regression, and a decision tree model were employed. RESULTS: The cohort comprised 207 patients with a median (interquartile range) age at admission of 6.2 (3.1
  12.9) months and a median follow-up of 29.4 (10.2
  49.6) months. Short bowel (85 %) and motility disorders (10.6 %) were the primary causes of intestinal failure. Cumulative incidence of 5-year for enteral autonomy and survival rates were 37 % and 88 %, respectively. Intestinal failure-associated liver disease was present in 24 % of patients on admission. Enteral autonomy was associated with remnant intestine length >
 40 cm (hazard ratio: 2.0
  95 % confidence interval: 1.7
  3.6)
  age at admission <
 6.2 months (hazard ratio: 1.8
  95 % confidence interval: 1.0
  3.3)
  and preserved ileocecal valve (hazard ratio: 3.4
  95 % confidence interval: 1.9
  6.0). The overall mortality rate was 7.7 %. CONCLUSION: The overall survival rate was 92.3 % and the 5-year cumulative incidence of enteral autonomy was 37 %. The probability of achieving enteral autonomy was associated with early arrival at the intestinal rehabilitation center and favorable bowel anatomy.