title: Canadian home total parenteral nutrition registry: preliminary data on the patient population.
abstract: BACKGROUND
  Long-term administration of home total parenteral nutrition (HTPN) has permitted patients with chronic intestinal failure to survive for prolonged periods of time. However, HTPN is associated with numerous complications, all of which increase morbidity and mortality. In Canada, a comprehensive review of the HTPN population has never been performed.
  
  
  OBJECTIVE
  To report on the demographics, current HTPN practice and related complications in the Canadian HTPN population.
  
  
  METHODS
  This was a cross-sectional study. Five HTPN programs in Canada participated. Patients' data were entered by the programs' TPN team into a Web site-based registry. A unique confidential record was created for each patient. Data were then downloaded into a Microsoft Excel (Microsoft Corp, USA) spreadsheet and imported into SPSS (SPSS Inc, USA) for statistical analysis.
  
  
  RESULTS
  One hundred fifty patients were entered into the registry (37.9% men and 62.1% women). The mean (+/- SD) age was 53.0+/-14 years and the duration requiring HTPN was 70.1+/-78.1 months. The mean body mass index before the onset of HTPN was 19.8+/-5.0 kg/m(2). The primary indication for HTPN was short bowel syndrome (60%) secondary to Crohn's disease (51.1%), followed by mesenteric ischemia (23.9%).
  
  
  RESULTS
  over one year, 62.7% of patients were hospitalized at least once, with 44% of hospitalizations related to TPN. In addition, 28.6% of patients had at least one catheter sepsis (double-lumen more than single-lumen; P=0.025) and 50% had at least one catheter change. Abnormal liver enzymes were documented in 27.4% of patients and metabolic bone disease in 60% of patients, and the mean Karnofsky score was 63.
  
  
  CONCLUSIONS
  In the present population sample, the data suggest that HTPN is associated with significant complications and health care utilization. These results support the use of a Canadian HTPN registry to better define the HTPN population, and to monitor complications for quality assurance and future research.
authors.affiliation: University Health Network, Toronto, Canada.
authors.forename: Maitreyi
authors.initials: M
authors.lastname: Raman
authors.forename: Leah
authors.initials: L
authors.lastname: Gramlich
authors.forename: Scott
authors.initials: S
authors.lastname: Whittaker
authors.forename: Johane P
authors.initials: JP
authors.lastname: Allard
mesh_terms: D000328:Adult; D000368:Aged; D001847:Bone Diseases / Q000378:metabolism; D002170:Canada / Q000453:epidemiology; D002405:Catheterization, Central Venous; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000628:therapy; D008099:Liver / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D016562:Parenteral Nutrition, Home Total / Q000009:adverse effects / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life; D012042:Registries