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A nordic multicente...
A nordic multicenter study on contemporary outcomes of pediatric short bowel syndrome in 208 patients
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- Mutanen, Annika (författare)
- Univ Helsinki, New Childrens Hosp, HUS, Dept Pediat Surg, Stenbackinkatu 9, Helsinki 00029, Finland.,University of Helsinki
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- Engstrand Lilja, Helene, 1963- (författare)
- Karolinska Institutet,Uppsala universitet,Barnkirurgisk forskning,Uppsala University Hospital
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- Wester, Tomas (författare)
- Karolinska Institutet,Karolinska Institute,Karolinska University Hospital
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- Norrby, Heimir (författare)
- Karolinska Univ Hosp, Unit Pediat Surg, Stockholm, Sweden.,Karolinska University Hospital
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- Borg, Helena (författare)
- Queen Silvia Childrens Hosp, Dept Pediat Surg, Gothenburg, Sweden.,Queen Silvia Children’s Hospital
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- Persson, Sara (författare)
- Queen Silvia Childrens Hosp, Dept Pediat Surg, Gothenburg, Sweden.,Queen Silvia Children’s Hospital
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- Bjornland, Kristin (författare)
- Oslo Univ Hosp, Dept Pediat Surg, Oslo, Norway.;Univ Oslo, Oslo, Norway.,Oslo university hospital
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- Brun, Anne Charlotte (författare)
- Oslo Univ Hosp, Dept Pediat Med, Oslo, Norway.,Oslo university hospital
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- Telborn, Lovisa (författare)
- Lund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Stenström, Pernilla (författare)
- Lund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Barnkirurgi,Forskargrupper vid Lunds universitet,LU profilområde: Ljus och material,Lunds universitets profilområden,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Pediatric surgery,Lund University Research Groups,LU Profile Area: Light and Materials,Lund University Profile areas,Skåne University Hospital
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- Pakarinen, Mikko P. (författare)
- Karolinska Institute,University of Helsinki
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Univ Helsinki, New Childrens Hosp, HUS, Dept Pediat Surg, Stenbackinkatu 9, Helsinki 00029, Finland University of Helsinki (creator_code:org_t)
- Elsevier, 2023
- 2023
- Engelska.
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 42:7, s. 1095-1103
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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http://dx.doi.org/10... (free)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background & aims: Despite advances in the management of short bowel syndrome related intestinal failure (SBS-IF), large-scale contemporary pediatric studies are scarce. The aim of this multicenter study was to assess key outcomes and clinical prognostic factors in a recent Nordic pediatric SBS-IF population.Methods: Patients with SBS-IF treated during 2010-2019, whose parenteral support (PS) started at age <1 year and continued >60 consecutive days were included and retrospectively reviewed. All six participating centers followed multidisciplinary SBS-IF management. Risk factors for PS dependency, intestinal failure associated liver disease (IFALD) and mortality were assessed with Cox regression and Kaplan Meier analyses. IFALD was defined with serum liver biochemistry levels.Results: Among 208 patients, SBS-IF resulted from NEC in 49%, gastroschisis w/wo atresia in 14%, small bowel atresia in 12%, volvulus in 11%, and other diagnoses in 14%. Median age-adjusted small bowel length was 43% (IQR 21-80%). After median follow up of 4.4 years (IQR 2.5-6.9), enteral autonomy was reached by 76%, none had undergone intestinal transplantation, and overall survival was 96%. Half of deaths (4/8) were caused by septic complications. Although biochemical cholestasis occurred only in 3% at latest follow-up and none of deaths were directly caused by IFALD, elevated liver biochemistry (HR 0.136; P = 0.017) and shorter remaining small bowel (HR 0.941; P = 0.040) predicted mortality. Shorter remaining small bowel and colon, and presence of end-ostomy were the main predictors of PS dependency, but not IFALD. Patients with NEC reached enteral autonomy more efficiently and had decreased incidence of IFALD compared to other etiologies.Conclusions: Although with current multidisciplinary management, prognosis of pediatric SBS is encouraging, septic complications and IFALD still associated with the remaining low mortality rate.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Intestinal failure
- Intestinal failure associated liver disease
- Epidemiology
- Mortality
- Necrotizing enterocolitis
- Multidisciplinary
- Epidemiology
- Intestinal failure
- Intestinal failure associated liver disease
- Mortality
- Multidisciplinary
- Necrotizing enterocolitis
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- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
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Mutanen, Annika
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Engstrand Lilja, ...
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Wester, Tomas
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Norrby, Heimir
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Borg, Helena
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Persson, Sara
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Bjornland, Krist ...
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Brun, Anne Charl ...
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Telborn, Lovisa
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Stenström, Perni ...
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Pakarinen, Mikko ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Gastroenterologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Pediatrik
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
- Artiklar i publikationen
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Clinical Nutriti ...
- Av lärosätet
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Uppsala universitet
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Lunds universitet
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Karolinska Institutet