title: Home parenteral nutrition in the United Kingdom and Ireland.
abstract: Between January, 1977, and March, 1986, 200 patients were registered as receiving home parenteral nutrition (HPN) in the UK and the Republic of Ireland. Although 28 centres contributed case-reports, 75% of the cases were registered by 7 centres. Most patients started treatment between the ages of 10 and 40 years, a reflection of the high incidence of Crohn's disease during these decades. The three main indications for HPN were Crohn's disease (90 patients), mesenteric vascular disease (27), and extensive small-bowel resection for volvulus or other benign enteric disease (14). 85 patients required treatment for less than 1 year and 17 have been on treatment for more than 2 years. Patients whose indication for HPN was a primary intestinal disease had a better quality of life than did those in whom the intestinal failure was secondary to a systemic disorder. Of the 108 patients who have completed treatment 56 have been able to resume enteral nutrition through adaptation of the remaining bowel, or closure of a fistula. 34 have died, 19 as a consequence of the underlying disease and 10 of complications of treatment. The incidence of catheter-related sepsis varied between 0.2 and 0.9 episodes per year of treatment (overall 0.35) depending on the length of experience of the supervising centre.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006699:Home Care Services; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000401:mortality / Q000628:therapy; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000628:therapy; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D011788:Quality of Life; D013997:Time Factors