Short bowel syndrome related intestinal failure outcomes in Latin America: Insights from the RESTORE Registry

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition Pub Date : 2024-10-05 DOI:10.1002/jpen.2693

Carolina Rumbo MD, Hector Solar MD, Mariana Ortega Lic, Verónica Busoni MD, Silvia de Barrio MD, Andrés Martinuzzi MD, María Ines Martínez MD, Clara Plata MD, Luciana Donnadio MD, Serralde-Zuñiga Aurora MD, Carola Saure MD, Claudia Perez MD, María Noel Tanzi MD, Alejandra Consuelo MD, Andrés Becerra MD, Alejandra Manzur MD, Diego Arenas Moya MD, Lorena Rudi MD, Eduardo Moreira MD, Martín Buncuga MD, María Isabel Hodgson MD, Rodrigo Sánchez Clariá MD, Adriana Fernandez MD, Gabriel Gondolesi MD

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引用次数: 0

Abstract

Background

Short bowel syndrome is considered a low prevalence disease. The scant information available about intestinal failure in Latin America was the driving force to expand this registry.

Methods

A prospective, multicenter observational registry was created for patients with chronic intestinal failure short bowel at specialized centers in Latin America. Demographics, clinical characteristics, nutrition assessment, parenteral nutrition management, intestinal rehabilitation, related complications, clinical outcome, and survival were analyzed.

Results

From May 2020 to July 2023, 167 patients (115 adults, 52 children) from 20 centers were enrolled. For the adults, the mean age was 37.2 ± 18 years, 48% were female, and the mean follow-up was 22.6 ± 18.3 months. The main etiology was surgical resections (postsurgical complications: 37%; ischemia: 25%); the mean intestinal length was 73 ± 55 cm. The complications were as follows: infections: 0.4/1000 catheter-days; thrombosis: 0.24/1000 catheter-days; liver disease: 2.6%. The outcomes were as follows: 28% were rehabilitated, 15% died, 9.6% were lost to follow-up, 0.9% underwent transplant, and 45.6% continued follow-up. For the children, the mean age 48 ± 52 months, 48% were female, 52% were premature. The mean follow-up was 17.2 ± 5.6 months; the mean remaining intestinal length was 38 ± 45 cm. The leading etiologies were atresia (25%), NEC (23%), and gastroschisis (21%). The complication were as follows: infections: 2/1000 catheter-days; thrombosis: 2.22/1000 catheter-day; 25% developed liver disease. The outcomes were as follows: 7.7% died, 3.8% were rehabilitated, and 88.5% continued follow-up.

Conclusion

The RESTORE amendment served as a registry and educational tool for the participating teams. The aspiration is to objectively show current aspects of intestinal failure in the region and carry them to international standards. Including all Latin American countries and etiologies of chronic intestinal failure besides short gut would serve to complete this registry.

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拉丁美洲与短肠综合征相关的肠功能衰竭结果：来自 RESTORE 登记处的启示。

背景：短肠综合征被认为是一种发病率较低的疾病。在拉丁美洲，有关肠功能衰竭的信息很少，这也是扩大该登记处的动力：方法：为拉丁美洲专业中心的慢性短肠综合征患者建立了前瞻性多中心观察登记。对人口统计学、临床特征、营养评估、肠外营养管理、肠道康复、相关并发症、临床结果和存活率进行了分析：结果：从 2020 年 5 月到 2023 年 7 月，来自 20 个中心的 167 名患者（115 名成人，52 名儿童）接受了治疗。成人患者的平均年龄为（37.2±18）岁，48%为女性，平均随访时间为（22.6±18.3）个月。主要病因是手术切除（手术后并发症：37%；缺血：25%）；平均肠长为 73 ± 55 厘米。并发症如下：感染：感染：0.4/1000 个导管日；血栓形成：0.24/1000 个导管日；肝脏疾病：2.6%：2.6%.结果如下：28%康复，15%死亡，9.6%失去随访，0.9%接受移植，45.6%继续随访。患儿的平均年龄为（48 ± 52）个月，48%为女性，52%为早产儿。平均随访时间为 17.2 ± 5.6 个月；平均剩余肠道长度为 38 ± 45 厘米。主要病因是肠闭锁（25%）、NEC（23%）和胃裂（21%）。并发症如下：感染：2/1000导管日；血栓形成：2.22/1000导管日；25%出现肝脏疾病。结果如下：7.7%的患者死亡，3.8%的患者康复，88.5%的患者继续随访：RESTORE修正案为参与团队提供了登记和教育工具。我们的目标是客观地展示该地区肠功能衰竭的现状，并将其与国际标准接轨。将所有拉美国家和除短肠以外的慢性肠功能衰竭病因纳入登记册将有助于完善该登记册。

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

Journal of Parenteral and Enteral Nutrition 医学-营养学

CiteScore

7.80

自引率

8.80%

发文量

161

审稿时长

6-12 weeks

期刊介绍： The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.