دورية أكاديمية
Predictors of 1-year enteral autonomy in children with intestinal failure: A descriptive retrospective cohort study.
| العنوان: | Predictors of 1-year enteral autonomy in children with intestinal failure: A descriptive retrospective cohort study. |
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| المؤلفون: | Raghu VK; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA., Leraas HJ; Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Samoylova M; Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Park C; Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Rothenberger SD; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA., Sudan D; Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Avitzur Y; Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. |
| المصدر: | JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2023 Nov; Vol. 47 (8), pp. 1047-1055. Date of Electronic Publication: 2023 Sep 06. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley Country of Publication: United States NLM ID: 7804134 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1941-2444 (Electronic) Linking ISSN: 01486071 NLM ISO Abbreviation: JPEN J Parenter Enteral Nutr Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : [Hoboken, NJ] : Wiley Original Publication: Thorofare, N. J., Slack. |
| مواضيع طبية MeSH: | Intestinal Failure* , Short Bowel Syndrome*/surgery, Humans ; Child ; Retrospective Studies ; Intestine, Small/surgery ; Intestines |
| مستخلص: | Introduction: The International Intestinal Failure Registry (IIFR) is an international consortium to study intestinal failure (IF) outcomes in a large contemporary pediatric cohort. We aimed to identify predictors of early (1-year) enteral autonomy. Methods: We included IIFR pilot phase patients. IF was defined by a parenteral nutrition need for at least 60 days due to a primary gastrointestinal etiology. The primary outcome was time to enteral autonomy achievement. We built a mixed-effects Weibull accelerated failure time model with random effects by center to analyze variables associated with enteral autonomy achievement with a primary outcome of time ratio (TR). Results: We included 189 patients (82% with short bowel syndrome) representing 11 international centers. Cumulative incidence of early enteral autonomy was 51.6%, and death was 6.5%. In multivariable analysis, ostomy presence (TR, 2.63; 95% CI, 1.41-4.90) was associated with increased time to enteral autonomy achievement, and Asian/Indian (TR, 0.28; 95% CI, 0.10-0.81) and Pacific Islander race (TR, 0.34; 95% CI, 0.13-0.90) were associated with decreased time to enteral autonomy achievement. In a second model in the subset with measured percentage of bowel length remaining, ostomy presence (TR, 4.21; 95% CI, 1.90-9.33) was associated with increased time to enteral autonomy achievement, whereas greater percentage of bowel remaining (TR, 0.96; 95% CI, 0.94-0.98) was associated with decreased time to enteral autonomy achievement. Conclusions: Minimizing bowel resection at initial surgery and establishing bowel continuity by ostomy reversal can effectively decrease the time to early enteral autonomy achievement in children with IF. (© 2023 American Society for Parenteral and Enteral Nutrition.) |
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| معلومات مُعتمدة: | KL2 TR001856 United States TR NCATS NIH HHS |
| فهرسة مساهمة: | Keywords: gastroenterology; outcomes research/quality; parenteral nutrition; pediatrics; short bowel syndrome |
| تواريخ الأحداث: | Date Created: 20230813 Date Completed: 20231107 Latest Revision: 20240206 |
| رمز التحديث: | 20240206 |
| مُعرف محوري في PubMed: | PMC10843595 |
| DOI: | 10.1002/jpen.2557 |
| PMID: | 37573479 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1941-2444 |
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| DOI: | 10.1002/jpen.2557 |