Neonatal short bowel syndrome outcomes after the establishment of the first Canadian multidisciplinary intestinal rehabilitation program: preliminary experience.
BACKGROUND
A multidisciplinary intestinal rehabilitation team has been in place at our institution for 3 years. Our goal was to compare the preliminary outcomes of neonates with short bowel syndrome before with those after the establishment of our formalized intestinal failure program (Group for the Improvement of Intestinal Function and Treatment [GIFT]).


METHODS
We conducted a retrospective analysis of our intestinal failure registry comparing preGIFT (1997-1999) with GIFT (2003-2005) outcomes.


RESULTS
Fifty-four patients (mean gestational age = 33.5 weeks) were included in the GIFT cohort, and 40 patients (mean gestational age = 30.7 weeks) formed the preGIFT cohort. Overall mortality rates (33.3% vs 37.5%, P = .84) were equivalent in the 2 cohorts, although fewer patients died of liver failure after the establishment of the GIFT. Among those with liver failure, the mortality in the preGIFT group was 9/10 as compared with that of 6/13 in the GIFT group (P = .03). The decrease in liver-related deaths was partly attributable to earlier referral for and increased survival to transplant (4 for the GIFT group vs 0 for the preGIFT group).


CONCLUSIONS
Analysis of the preliminary outcomes of the GIFT program suggests that the natural history of neonatal short bowel syndrome remains unaltered to date despite a coordinated approach to care. However, improved communication and integration with the transplant service have resulted in earlier assessment, increased rates of transplantation, and decreased mortality from liver failure.
Diamond
Ivan R
IR
Division of General Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.
de Silva
Nicole
N
Pencharz
Paul B
PB
Kim
Jae H
JH
Wales
Paul W
PW
D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009864:Ontario / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000401:mortality / Q000628:therapy*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome