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Long-term survival of patients with intestinal failure requiring home parenteral nutrition (HPN) has not been clearly shown. The authors describe the survival of these patients and explore the prognostic factors. A total of 217 non-cancer non-AIDS adult patients presenting with chronic intestinal failure enrolled from January 1980 to December 1989 in approved HPN programs in Belgium and France. Data were updated in March 1991; not one of the patients was lost for follow up. The prognosis factors for survival are explored using multivariate analysis. During the survey 73 patients died, and the mortality rate related to HPN complications accounted for 11% of deaths. Probabilities of survival at 1, 3 and 5 years were 91%, 70%, and 62% respectively. Three independent variables were associated with a decreased risk of death: age of patients younger than 40 years, start of HPN after 1987, and absence of chronic intestinal obstruction. In patients younger than 60 years, included after 1983 and with a very short bowel (or = 50 cm), (who could represent suitable candidates for small bowel transplantation) the 2-year survival rate was 90%, a prognosis that compares favourably with recent reports on survival after small bowel transplantation. In conclusion, HPN prognosis compares favourably with recent reports of survival after small bowel transplantation. |
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