Long-term outcome and quality of life of adult patients on home parenteral nutrition.
The outcome and prognosis of home parenteral nutrition (HPN) patients may depend on their age and underlying disease and on HPN techniques. Results in the literature are confounded by mixing child and adult populations, short- and long-term HPN treatments and malignant and non-malignant cases. Only four papers have reported the probability of survival and only one of these used multivariate analysis. The quality of life of HPN patients, focusing on community and social rehabilitation, has been reported. The aspects of treatment differ depending upon the circumstances under which HPN is started (acute vs chronic) and the nature of the disease, facts which have to be taken into account in patient management. Prognosis of the underlying disease obviously has a major influence on how rehabilitation is viewed. Patients should be informed of the objectives of HPN by the nutrition team and family circumstances taken into account, before time-consuming and expensive HPN treatment is started.
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Hôpital Saint-Lazare, Service d'Hépato-Gastro-Entérologie et de Nutrition, Centre agréé de Nutrition Parentérale á Domicile, INSERM U290, 107 bis rue du Faubourg Saint-Denis, 75010 Paris, France.