Department of Clinical Nutrition and Dietetics, Medical University of Gdansk, 80-210 Gdańsk, Poland.
Home Enteral and Parenteral Nutrition Unit, General Surgery Department, Nicolaus Copernicus Hospital, 80-803 Gdańsk, Poland.
Nutrients. 2021 Sep 29;13(10):3465. doi: 10.3390/nu13103465.
The population of patients on home parenteral nutrition (HPN) worldwide is growing. Since only a few counties provide data from national registries long-term observations are valuable to address this specific area of nutrition support. This study is a nationwide analysis determining the trends in the epidemiology of HPN (prevalence, age distribution, death rates), indications for HPN, causes for hospitalizations, and cost analysis of HPN reimbursement in Poland between 2010-2020.
A retrospective analysis of data obtained from the national health fund (NHF) of Poland on adult patients on HPN.
The prevalence of adult patients on HPN in Poland in 2020 was 53.26 per million citizens with a 2.99-fold increase and a growing trend observed from 2010. Significant decrease in the percentage of patients between 18-34, 45-54 and an increase in patients between 65-74 and patients over 75 years old was observed. Trend analysis showed an increase in new patients between 65-74 and a decrease between 35-54. Malnutrition (34.28%), postprocedural disorders of the GI tract (19.61%), intestinal malabsorption/other intestinal diseases (20.41%) and GI obstruction due to cancer (17.36% as primary and 23.16% as secondary diagnosis) were mostly reported as the primary indications for HPN. Cancer patients were mostly gastric, ovarian and colon cancer (34.74%, 17.83% and 12.3%). HPN and total health cost reimbursement increase was 2.6 and 2.57-fold respectively. Costs of HPN and total health care costs in 2020 per patient were € 10,015 and € 16,038, respectively. Overall death risk rate during the first year of nutrition was 0.59 with a significant increase in the observation period -trend < 0.004. A significant increase in the death rate was observed in patients above 75 years old (estimate 1.629, -trend < 0.030). Cancer, infection, malnutrition and GI symptoms were the most common indications for hospitalizations of HPN patients. The rate of patients with a maximal length of HPN of 5 months in 2010 was 54.9% and was growing up to 78.1% in 2020.
The prevalence of HPN in Poland is growing. Trends of age distribution show increasing numbers of patients with more advanced age and shorter survival. Costs of HPN are comparable with other European data.
全球接受家庭肠外营养（HPN）的患者人数不断增加。由于只有少数几个国家提供全国登记册的数据，因此长期观察对于解决这一特定营养支持领域非常有价值。本研究是一项全国性分析，旨在确定波兰 HPN 流行病学（患病率、年龄分布、死亡率）的趋势、HPN 的适应证、住院原因以及 HPN 报销的成本分析，时间跨度为 2010 年至 2020 年。
对波兰国家健康基金（NHF）获取的成年 HPN 患者数据进行回顾性分析。
2020 年，波兰成年 HPN 患者的患病率为每百万居民 53.26 人，患病率增加了 2.99 倍，呈上升趋势，自 2010 年以来观察到这种趋势。18-34 岁、45-54 岁患者的比例显著下降，65-74 岁和 75 岁以上患者的比例增加。趋势分析显示，65-74 岁之间的新患者数量增加，而 35-54 岁之间的患者数量减少。营养不良（34.28%）、胃肠道术后紊乱（19.61%）、肠吸收不良/其他肠道疾病（20.41%）和癌症引起的胃肠道梗阻（原发性 17.36%，继发性 23.16%）主要作为 HPN 的主要适应证。癌症患者主要为胃癌、卵巢癌和结肠癌（34.74%、17.83%和 12.3%）。HPN 和总健康费用报销分别增加了 2.6 倍和 2.57 倍。2020 年每位患者的 HPN 治疗和总医疗费用分别为 10015 欧元和 16038 欧元。营养治疗第一年的整体死亡风险率为 0.59%，观察期间呈显著上升趋势-趋势<0.004。75 岁以上患者的死亡率显著上升（估计值 1.629，-趋势<0.030）。癌症、感染、营养不良和胃肠道症状是 HPN 患者住院的最常见原因。2010 年 HPN 最长持续时间为 5 个月的患者比例为 54.9%，到 2020 年上升至 78.1%。
波兰 HPN 的患病率呈上升趋势。年龄分布趋势显示，年龄较大和生存时间较短的患者数量不断增加。HPN 的费用与其他欧洲数据相当。
Zotero 插件