Textbook outcome in short bowel syndrome

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-09-14 DOI:10.1016/j.amjsurg.2024.115972

Jon S. Thompson , Fedja A. Rochling , Elizabeth Lyden , Shaheed Merani , Luciano Vargas , Wendy J. Grant , Alan N. Langnas , David F. Mercer

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Abstract

Background

Textbook outcome (TO) is a single composite score representing ideal care for a procedure or medical condition. Short bowel syndrome (SBS) patients are at high risk for complications and death. Our aim was to determine the incidence of and predictive factors for a TO in SBS patients.

Methods

515 adults with SBS were followed for 12 months after initial hospital discharge for SBS. TO was defined based on eight outcome parameters. Demographic data, intestinal anatomy, and nutritional outcome were compared in patients with and without TO.

Results

78 (15 %) patients had a TO. The frequency of the different components of TO were: PN < 1 year (39 %), BMI >18.5 kg/m² (89 %), no stoma (59 %), no surgical intervention (71 %), no hospital readmission (56 %), no vascular access infection (62 %), absence of end stage liver disease (96 %), and survival (97 %). Intestinal remnant length and anatomy type were predictive of a TO.

Conclusions

A TO is achieved in 15 % SBS patients using the selected criteria. This is largely attributable to continued need for PN. Intestinal length and anatomy were independent predictors of TO.

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短肠综合征的教科书结果

背景手册结果（TO）是一个单一的综合评分，代表了手术或医疗条件的理想护理效果。短肠综合征（SBS）患者是并发症和死亡的高危人群。我们的目的是确定SBS患者TO的发生率和预测因素。TO的定义基于八个结果参数。结果78例（15%）患者出现了TO。78例（15%）患者出现了TO，TO的不同组成部分的频率分别为PN<1年（39%）、BMI>18.5 kg/m2（89%）、无造口（59%）、无手术干预（71%）、无再入院（56%）、无血管通路感染（62%）、无终末期肝病（96%）和存活（97%）。结论根据所选标准，15% 的 SBS 患者可获得 TO。这主要归因于继续需要 PN。肠道长度和解剖类型是预测 TO 的独立因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.