Expenditure and survival of adult patients with intestinal failure due to short bowel syndrome: real-world evidence from Southern Finland.

Autor: Ukkola-Vuoti L; Real World Evidence, Medaffcon Oy, Espoo, Finland., Tuominen S; Real World Evidence, Medaffcon Oy, Espoo, Finland., Pohju A; Clinical Nutrition Unit, Internal Medicine and Rehabilitation, Helsinki University Hospital, Helsinki, Finland., Kovac B; Gastroenterolgy Department, Takeda Oy, Helsinki, Finland., Lassenius MI; Real World Evidence, Medaffcon Oy, Espoo, Finland., Merras-Salmio L; Helsinki University Hospital, Pediatric Gastroenterology Unit, University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Pakarinen MP; Section of Pediatric Surgery, Pediatric Liver and Gut Research Group, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.; Department of Women's Health, Karolinska Institute, Solna, Sweden., Sallinen V; Gastroenterological Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Pikkarainen S; Abdomen Center, Gastroenterology Unit, Helsinki University Hospital, Helsinki, Finland.
Jazyk: angličtina
Zdroj: Scandinavian journal of gastroenterology [Scand J Gastroenterol] 2024 Apr; Vol. 59 (4), pp. 401-410. Date of Electronic Publication: 2024 Jan 13.
DOI: 10.1080/00365521.2024.2303063
Abstrakt: Objectives: Comprehensive follow-up data from the largest hospital district in Finland was used to assess hospital-based healthcare resource utilization (HCRU) and expenses, incidence and prevalence, survival, and effect of comorbidities/complications on survival of adult patients with intestinal failure due to short bowel syndrome (SBS-IF).
Methods: This study utilized electronic healthcare data covering all ≥18-year-old patients with SBS-IF at the Hospital District of Helsinki and Uusimaa in Finland between 2010 and 2019. Patients were followed from SBS-IF onset until the end of 2020 or death and compared to birth year and sex-matched control patients without SBS-IF.
Results: The study included 77 patients with SBS-IF (cases) and 363 controls. Cases had high HCRU; the cumulative expenses were about tenfold compared to the controls, at the end of the study (€123,000 vs. €14,000 per patient). The expenses were highest during the first year after SBS-IF onset (€53,000 per patient). Of the cases with a median age 62.5 years, 51.9% died during study time. The median survival was 4.4 years from SBS-IF onset and cases died 13.5 times more likely during the follow-up compared to controls. Mortality risk was lower in female cases (hazard ratio (HR) 0.46; 95% confidence intervals (CI) 0.24, 0.9) and higher with presence of comorbidities (Charlson comorbidity index HR 1.55; 95% CI 1.2, 2.0) and mesenteric infarction (HR 4.5; 95% CI 1.95, 10.36). The incidence of adult SBS-IF was 0.6 per 100,000 adults.
Conclusion: Our study demonstrates a high demand for healthcare support and elevated mortality in adult SBS-IF-patients. Our results suggest that the presence of comorbidities is a key driver for mortality.
Databáze: MEDLINE