Paccagnella Agostino, Baruffi Carla, Pizzolato Daniella, Favaro Vittorino, Marcon Maria Lisa, Morello Michela, Semenzin Mariateresa, Rebuffi Stefania, Fossa Elena, Faronato Pierpaolo, Spinella Nello, Tessarin Michele, Foscolo Giancarlo
Department of Medicine, Nutritional Service, Treviso Healthcare Authority, Treviso, Italy.
Clin Nutr. 2008 Jun;27(3):378-85. doi: 10.1016/j.clnu.2008.03.005. Epub 2008 May 19.
In the last twenty years Home Enteral Nutrition (HEN) has undergone considerable development and has determined economic and organisational changes. The aim of this study is to evaluate the epidemiological data of 655 patients treated in the five-year period (2001-2005) in an area in the North-East of Italy.
The following data were analysed at the initiation of HEN: age, sex, pathology, Karnofsky index, type of enteral access device, presence of pressure ulcers, weight, body mass index, haematochemical tests, daily enteral intake. Length of therapy and patient survival were then considered. The outcome was based on patient mortality and the patient's ability to resume oral nutrition.
HEN was prescribed for the following pathologies: 26.7% neurovascular, 40.9% neurodegenerative, 11.5% head-neck cancer, 9.8% abdominal cancer, 1.5% head injury, 2.6% congenital anomaly, 7.0% other pathologies. Before commencement of enteral feeding an average of 22.9% weight loss from past weight was observed across all indications for HEN. Mean incidence (cases/10(6) inhabitants/year) and prevalence (cases/10(6) inhabitants) were respectively 308.7 (range 80.7-355.6) and 379.8 (range 138.7-534.6). The median length of HEN was 196 days; only 7.9% of patients resumed oral nutrition. The median survival rate was 9.1 months and resulted influenced by age (Odds ratio: 1.80; 95% Confidence Interval: 1.19-2.72), sex (0.22; 0.08-0.59), and Karnofsky index (0.65; 0.43-0.97). Resumption of oral nutrition was influenced by age (0.50; 0.36-0.68), sex (2.50; 1.23-5.06), Karnofsky index (1.55; 1.15-2.10) and type of enteral access device (0.44; 0.26-0.76).
Efficient organisation means being able to look after a greater number of patients undergoing HEN, raising awareness regarding the nutritional treatment.
在过去二十年中，家庭肠内营养（HEN）取得了显著发展，并引发了经济和组织方面的变革。本研究旨在评估意大利东北部一个地区在五年期间（2001 - 2005年）接受治疗的655例患者的流行病学数据。
在开始进行家庭肠内营养时分析以下数据：年龄、性别、病情、卡诺夫斯基指数、肠内营养通路装置类型、压疮情况、体重、体重指数、血液生化检查、每日肠内营养摄入量。随后考虑治疗时长和患者生存率。结果基于患者死亡率以及患者恢复经口营养的能力。
家庭肠内营养应用于以下病情：神经血管疾病占26.7%，神经退行性疾病占40.9%，头颈癌占11.5%，腹部癌占9.8%，头部损伤占1.5%，先天性异常占2.6%，其他病情占7.0%。在开始肠内喂养前，所有家庭肠内营养适应证患者的体重较之前平均减轻了22.9%。平均发病率（例/10⁶居民/年）和患病率（例/10⁶居民）分别为308.7（范围80.7 - 355.6）和379.8（范围138.7 - 534.6）。家庭肠内营养的中位时长为196天；只有7.9%的患者恢复了经口营养。中位生存率为9.1个月，且受年龄（优势比：1.80；95%置信区间：1.19 - 2.72）、性别（0.22；0.08 - 0.59）和卡诺夫斯基指数（0.65；0.43 - 0.97）影响。恢复经口营养受年龄（0.50；0.36 - 0.68）、性别（2.50；1.23 - 5.06）、卡诺夫斯基指数（1.55；1.15 - 2.10）和肠内营养通路装置类型（0.44；0.26 - 0.76）影响。
高效的组织意味着能够照顾更多接受家庭肠内营养的患者，提高对营养治疗的认识。
