Division of Clinical Nutrition, Department of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
Department of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Nutr Clin Pract. 2023 Jun;38(3):657-663. doi: 10.1002/ncp.10926. Epub 2022 Oct 29.
Current guidelines recommend that patients with chronic intestinal failure (CIF) should be managed by a multidisciplinary team (MDT). However, the characteristics of real-world IF centers and the patients they care for are lacking. The study aims to describe IF center characteristics as well as characteristics of patients with CIF across different global regions.
This is an international multicenter study of adult IF centers using a survey. The questionnaire survey included questions regarding program and patient characteristics. Thirty-three investigational centers were invited to participate. Each center was asked to answer the survey questions as one MDT.
The survey center response rate was 91%. The median number of patients with CIF per center was 128 (range, 30-380). The most common disciplines reported were gastroenterologist (93%), dietitian (90%), nurse (83%), and advanced practitioner (nurse practitioner and physician assistant, 77%). There were centers that did not have a pharmacist, surgeon, psychologist, and social worker (30%, 37%, 60%, and 70%, respectively). The median full-time equivalents (FTEs) per 100 patients were 1.1 for nurses, 1 for dietitians, 1 for advanced practitioners, and 0.9 for gastroenterologists. Short bowel syndrome was the most common cause of CIF (50%) followed by intestinal dysmotility (20%).
The majority of centers were managing around 100 patients with CIF. Despite the widespread use of the MDT, there are some variances in team characteristics. Gastroenterologists were the most common physicians supporting MDTs. In IF centers, one FTE of each core discipline was supported to manage 100 patients with CIF.
目前的指南建议慢性肠衰竭（CIF）患者应由多学科团队（MDT）管理。然而，现实世界中 IF 中心的特点以及他们所照顾的患者的特点尚不清楚。本研究旨在描述 IF 中心的特点以及不同全球区域 CIF 患者的特点。
这是一项针对成人 IF 中心的国际多中心研究，采用问卷调查。问卷包括有关项目和患者特征的问题。邀请了 33 个研究中心参与。每个中心都被要求作为一个 MDT 回答调查问题。
调查中心的回复率为 91%。每个中心 CIF 患者的中位数为 128 例（范围为 30-380 例）。报告的最常见学科是胃肠病学家（93%）、营养师（90%）、护士（83%）和高级从业人员（护士执业医师和医师助理，77%）。有些中心没有药剂师、外科医生、心理学家和社会工作者（分别为 30%、37%、60%和 70%）。每 100 例患者的护士、营养师、高级从业人员和胃肠病学家的全职等效人员中位数分别为 1.1、1、1 和 0.9。短肠综合征是 CIF 的最常见原因（50%），其次是肠动力障碍（20%）。
大多数中心都在管理大约 100 名 CIF 患者。尽管广泛使用 MDT，但团队特征存在一些差异。胃肠病学家是支持 MDT 的最常见医生。在 IF 中心，每个核心学科的一个 FTE 负责管理 100 名 CIF 患者。
