title: Long-term outcome of children receiving home parenteral nutrition: a 20-year single-center experience in 302 patients.
abstract: BACKGROUND
  More information is needed regarding the prognosis of children receiving home parenteral nutrition (HPN). This article describes 20-year outcome data in children receiving HPN and provides separate profiles for the major pediatric diagnostic subgroups.
  
  
  METHODS
  This retrospective study included children who started receiving HPN between January 1, 1980, and December 31, 1999, in a single pediatric HPN center.
  
  
  RESULTS
  A total of 302 children were recruited, 230 (76%) with primary digestive disorders and 72 (24%) with nonprimary digestive disorders. Median age at HPN onset was 1.5 years. Median duration of HPN was 1.3 years. By January 1, 2000, 54% had weaned from HPN, 26% were still receiving HPN, 16% had died, and 4% had undergone intestinal transplantation. The survival probabilities at 2, 5, 10, and 15 years were 97%, 89%, 81%, and 72%, respectively. The likelihood and cause of death depended on the underlying diagnosis. Nine percent of children with primary digestive disorders died, 24% from their primary disease and 48% from liver disease or sepsis. Children with intractable diarrhea of infancy had the highest mortality rate (25%) and the highest incidence of liver disease (48%; P = 0.0002). Thirty-eight percent of children with primary nondigestive diseases died, 94% from their primary disease and 6% from liver disease or sepsis.
  
  
  CONCLUSIONS
  Outcome and survival of children receiving HPN are mainly determined by their underlying diagnosis. Nearly all children with primary digestive disease survive if referred early to an expert center.
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition and HPN Center, Necker-Enfants Malades Hospital, Paris, France. virginie.colomb@nck.ap-hop-paris.fr
authors.forename: Virginie
authors.initials: V
authors.lastname: Colomb
authors.forename: Myriam
authors.initials: M
authors.lastname: Dabbas-Tyan
authors.forename: Pierre
authors.initials: P
authors.lastname: Taupin
authors.forename: Cécile
authors.initials: C
authors.lastname: Talbotec
authors.forename: Y
authors.initials: Y
authors.lastname: Révillon
authors.forename: D
authors.initials: D
authors.lastname: Jan
authors.forename: Sophie
authors.initials: S
authors.lastname: De Potter
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Gorski-Colin
authors.forename: Michèle
authors.initials: M
authors.lastname: Lamor
authors.forename: Karen
authors.initials: K
authors.lastname: Herreman
authors.forename: Odile
authors.initials: O
authors.lastname: Corriol
authors.forename: Paul
authors.initials: P
authors.lastname: Landais
authors.forename: Claude
authors.initials: C
authors.lastname: Ricour
authors.forename: Olivier
authors.initials: O
authors.lastname: Goulet
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000601:surgery / Q000628:therapy*; D008297:Male; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis