Messing B, Lémann M, Landais P, Gouttebel M C, Gérard-Boncompain M, Saudin F, Vangossum A, Beau P, Guédon C, Barnoud D
Hôpital Saint-Lazare, Paris, France.
Gastroenterology. 1995 Apr;108(4):1005-10. doi: 10.1016/0016-5085(95)90196-5.
BACKGROUND/AIMS: Long-term survival of patients with intestinal failure requiring home parenteral nutrition (HPN) has been only partly shown. Therefore, we described the survival of these patients and explored prognosis factors.
Two hundred seventeen noncancer non-acquired immunodeficiency syndrome adult patients presenting with chronic intestinal failure enrolled from January 1980 to December 1989 in approved HPN programs in Belgium and France; prognosis factors of survival were explored using multivariate analysis. Data were updated in March 1991; not one of the patients was lost to follow-up.
Seventy-three patients died during the survey, and the mortality rate related to HPN complications accounted for 11% of deaths. Probabilities of survival at 1, 3, and 5 years were 91%, 70%, and 62%, respectively. Three independent variables were associated with a decreased risk of death: age of patients younger than 40 years, start of HPN after 1987, and absence of chronic intestinal obstruction. In patients younger than 60 years of age included after 1983 with a very short bowel, who could represent suitable candidates for small bowel transplantation, the 2-year survival rate was 90%, a prognosis that compared favorably with recent reports of survival after small bowel transplantation.
HPN prognosis compares favorably with recent reports of survival after small bowel transplantation.
背景/目的：需要家庭肠外营养（HPN）的肠衰竭患者的长期生存情况仅部分得到证实。因此，我们描述了这些患者的生存情况并探讨了预后因素。
1980年1月至1989年12月期间，在比利时和法国批准的HPN项目中纳入了217例非癌症、非获得性免疫缺陷综合征的成年慢性肠衰竭患者；使用多变量分析探讨生存的预后因素。数据于1991年3月更新；没有一名患者失访。
73例患者在调查期间死亡，与HPN并发症相关的死亡率占死亡人数的11%。1年、3年和5年的生存率分别为91%、70%和62%。三个独立变量与死亡风险降低相关：年龄小于40岁的患者、1987年后开始HPN以及无慢性肠梗阻。在1983年后纳入的年龄小于60岁且小肠很短的患者中，这些患者可能是小肠移植的合适候选者，其2年生存率为90%，这一预后与近期小肠移植后的生存报告相比有利。
HPN的预后与近期小肠移植后的生存报告相比有利。
