Patient characteristics and clinical outcomes in a specialised intestinal failure unit:An observational cohort study
| Autor: | Lars Lemming, Simon Lal, Simon Mark Dahl Jørgensen, Marcel Kjærsgaard Eriksen, Jens Frederik Dahlerup, Christian Lodberg Hvas |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Parenteral Nutrition medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Patient characteristics 030209 endocrinology & metabolism Cohort Studies 03 medical and health sciences 0302 clinical medicine Intestinal failure Internal medicine medicine Central Venous Catheters Humans Multiple morbidities 030109 nutrition & dietetics Nutrition and Dietetics business.industry Short bowel syndrome medicine.disease Parenteral nutrition Confidence interval Intestines Catheter-Related Infections business Enteral nutrition Central venous catheter Cohort study |
| Zdroj: | Eriksen, M K, Jørgensen, S M D, Lemming, L E, Lal, S, Dahlerup, J F & Hvas, C L 2020, ' Patient characteristics and clinical outcomes in a specialised intestinal failure unit : An observational cohort study ', Clinical Nutrition ESPEN, vol. 38, pp. 253-262 . https://doi.org/10.1016/j.clnesp.2020.04.002 |
| Popis: | BACKGROUND: Intestinal failure (IF) is defined by a need for intravenous (IV) supplementation. Patients may present with multiple morbidities, and IV treatments carry a risk for catheter-related complications. Few studies described patient characteristics and clinical outcomes according to type of IF.METHODS: We consecutively included patients who were admitted to a newly established inpatient IF unit (IFU) from 2013 through 2017. We evaluated patient characteristics and clinical outcomes of all patients' first admission. Outcomes included IF classification, length of stay, central line-associated blood stream infection (CLABSI), and discharge on home parenteral support (HPS). Follow-up was conducted six months after discharge for mortality and the continued need for HPS.RESULTS: A total of 236 patients were evaluated, including 39 (17%) with type 1 IF, 123 (52%) with type 2 IF, and 74 (31%) with type 3 IF. Of 91 who had a central venous catheter (CVC) on admission, CLABSI was present in 11 (12%). The CLABSI occurrence during admission was 2 (1%) of 173 patients with a CVC. Mean length of stay declined from mean 33 days (95% confidence interval (CI): 26.2-42.5) in 2013 to 15 days (95% CI: 12.2-17.7) in 2017 (p < 0.0001). Undiagnosed comorbidity was revealed in 165 patients (70%) with unchanged frequency during the study period (p = 0.8). Sixty-seven (28%) patients were discharged with HPS.CONCLUSIONS: Inpatients with IF present with multiple morbidities. CLABSI should be investigated on admission. A low inpatient CLABSI rate may be achieved through the implementation of a specialised IFU. |
| Databáze: | OpenAIRE |
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