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Incidence and Outcomes of Home Parenteral Nutrition in Patients With Crohn Disease in Olmsted County, Minnesota

BACKGROUND: We sought to estimate the incidence of home parenteral nutrition (HPN) use in a population-based cohort of patients with Crohn disease (CD), and to assess clinical outcomes and complications associated with HPN. METHODS: We used the Rochester Epidemiology Project (REP) to identify reside...

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Autores principales: Bakhshi, Zeinab, Yadav, Siddhant, Salonen, Bradley R, Bonnes, Sara L, Varayil, Jithinraj Edakkanambeth, Harmsen, William Scott, Hurt, Ryan T, Tremaine, William J, Loftus, Edward V
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202468/
https://www.ncbi.nlm.nih.gov/pubmed/34142084
http://dx.doi.org/10.1093/crocol/otaa083
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author Bakhshi, Zeinab
Yadav, Siddhant
Salonen, Bradley R
Bonnes, Sara L
Varayil, Jithinraj Edakkanambeth
Harmsen, William Scott
Hurt, Ryan T
Tremaine, William J
Loftus, Edward V
author_facet Bakhshi, Zeinab
Yadav, Siddhant
Salonen, Bradley R
Bonnes, Sara L
Varayil, Jithinraj Edakkanambeth
Harmsen, William Scott
Hurt, Ryan T
Tremaine, William J
Loftus, Edward V
author_sort Bakhshi, Zeinab
collection PubMed
description BACKGROUND: We sought to estimate the incidence of home parenteral nutrition (HPN) use in a population-based cohort of patients with Crohn disease (CD), and to assess clinical outcomes and complications associated with HPN. METHODS: We used the Rochester Epidemiology Project (REP) to identify residents of Olmsted County, who were diagnosed with CD between 1970 and 2011, and required HPN. RESULTS: Fourteen out of 429 patients (3.3%) with CD received HPN (86% female). Eleven patients (79%) had moderate–severe CD and 12 patients (86%) had fistulizing disease. Thirteen patients (93%) underwent surgery, primarily due to obstruction. Among CD incidence cases, the cumulative incidence of HPN from the date of CD diagnosis was 0% at 1 year, 0.5% at 5 years, 0.8% at 10 years, and 2.4% at 20 years. Indications for HPN included short bowel syndrome in 64%, malnutrition in 29%, and bowel rest in 21%. The median duration of HPN was 2.5 years. There was an average weight gain of 1.2 kg at 6 months, an average weight loss of 1.4 kg at 1 year, and a further weight loss of 2.2 kg at 2 years from the start of HPN. Patients were hospitalized a mean of 5 times after the start of HPN, mainly due to catheter-related bloodstream infections and thrombosis. CONCLUSIONS: Less than 4% of patients with CD need HPN. Most have moderate to severe disease with short bowel syndrome or malnutrition. Possible reasons for the patients’ weight loss could be noncompliance, and increased metabolic needs because of active disease.
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spelling pubmed-82024682021-06-15 Incidence and Outcomes of Home Parenteral Nutrition in Patients With Crohn Disease in Olmsted County, Minnesota Bakhshi, Zeinab Yadav, Siddhant Salonen, Bradley R Bonnes, Sara L Varayil, Jithinraj Edakkanambeth Harmsen, William Scott Hurt, Ryan T Tremaine, William J Loftus, Edward V Crohns Colitis 360 Observations and Research BACKGROUND: We sought to estimate the incidence of home parenteral nutrition (HPN) use in a population-based cohort of patients with Crohn disease (CD), and to assess clinical outcomes and complications associated with HPN. METHODS: We used the Rochester Epidemiology Project (REP) to identify residents of Olmsted County, who were diagnosed with CD between 1970 and 2011, and required HPN. RESULTS: Fourteen out of 429 patients (3.3%) with CD received HPN (86% female). Eleven patients (79%) had moderate–severe CD and 12 patients (86%) had fistulizing disease. Thirteen patients (93%) underwent surgery, primarily due to obstruction. Among CD incidence cases, the cumulative incidence of HPN from the date of CD diagnosis was 0% at 1 year, 0.5% at 5 years, 0.8% at 10 years, and 2.4% at 20 years. Indications for HPN included short bowel syndrome in 64%, malnutrition in 29%, and bowel rest in 21%. The median duration of HPN was 2.5 years. There was an average weight gain of 1.2 kg at 6 months, an average weight loss of 1.4 kg at 1 year, and a further weight loss of 2.2 kg at 2 years from the start of HPN. Patients were hospitalized a mean of 5 times after the start of HPN, mainly due to catheter-related bloodstream infections and thrombosis. CONCLUSIONS: Less than 4% of patients with CD need HPN. Most have moderate to severe disease with short bowel syndrome or malnutrition. Possible reasons for the patients’ weight loss could be noncompliance, and increased metabolic needs because of active disease. Oxford University Press 2020-10-21 /pmc/articles/PMC8202468/ /pubmed/34142084 http://dx.doi.org/10.1093/crocol/otaa083 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Observations and Research
Bakhshi, Zeinab
Yadav, Siddhant
Salonen, Bradley R
Bonnes, Sara L
Varayil, Jithinraj Edakkanambeth
Harmsen, William Scott
Hurt, Ryan T
Tremaine, William J
Loftus, Edward V
Incidence and Outcomes of Home Parenteral Nutrition in Patients With Crohn Disease in Olmsted County, Minnesota
title Incidence and Outcomes of Home Parenteral Nutrition in Patients With Crohn Disease in Olmsted County, Minnesota
title_full Incidence and Outcomes of Home Parenteral Nutrition in Patients With Crohn Disease in Olmsted County, Minnesota
title_fullStr Incidence and Outcomes of Home Parenteral Nutrition in Patients With Crohn Disease in Olmsted County, Minnesota
title_full_unstemmed Incidence and Outcomes of Home Parenteral Nutrition in Patients With Crohn Disease in Olmsted County, Minnesota
title_short Incidence and Outcomes of Home Parenteral Nutrition in Patients With Crohn Disease in Olmsted County, Minnesota
title_sort incidence and outcomes of home parenteral nutrition in patients with crohn disease in olmsted county, minnesota
topic Observations and Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202468/
https://www.ncbi.nlm.nih.gov/pubmed/34142084
http://dx.doi.org/10.1093/crocol/otaa083
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