Home enteral nutrition in adults: a five-year (2001-2005) epidemiological analysis.
BACKGROUND
In the last twenty years Home Enteral Nutrition (HEN) has undergone considerable development and has determined economic and organisational changes. The aim of this study is to evaluate the epidemiological data of 655 patients treated in the five-year period (2001-2005) in an area in the North-East of Italy.


METHODS
The following data were analysed at the initiation of HEN: age, sex, pathology, Karnofsky index, type of enteral access device, presence of pressure ulcers, weight, body mass index, haematochemical tests, daily enteral intake. Length of therapy and patient survival were then considered. The outcome was based on patient mortality and the patient's ability to resume oral nutrition.


RESULTS
HEN was prescribed for the following pathologies: 26.7% neurovascular, 40.9% neurodegenerative, 11.5% head-neck cancer, 9.8% abdominal cancer, 1.5% head injury, 2.6% congenital anomaly, 7.0% other pathologies. Before commencement of enteral feeding an average of 22.9% weight loss from past weight was observed across all indications for HEN. Mean incidence (cases/10(6) inhabitants/year) and prevalence (cases/10(6) inhabitants) were respectively 308.7 (range 80.7-355.6) and 379.8 (range 138.7-534.6). The median length of HEN was 196 days; only 7.9% of patients resumed oral nutrition. The median survival rate was 9.1 months and resulted influenced by age (Odds ratio: 1.80; 95% Confidence Interval: 1.19-2.72), sex (0.22; 0.08-0.59), and Karnofsky index (0.65; 0.43-0.97). Resumption of oral nutrition was influenced by age (0.50; 0.36-0.68), sex (2.50; 1.23-5.06), Karnofsky index (1.55; 1.15-2.10) and type of enteral access device (0.44; 0.26-0.76).


CONCLUSIONS
Efficient organisation means being able to look after a greater number of patients undergoing HEN, raising awareness regarding the nutritional treatment.
Paccagnella
Agostino
A
Department of Medicine, Nutritional Service, Treviso Healthcare Authority, Treviso, Italy. apaccagnella@ulss.tv.it
Baruffi
Carla
C
Pizzolato
Daniella
D
Favaro
Vittorino
V
Marcon
Maria Lisa
ML
Morello
Michela
M
Semenzin
Mariateresa
M
Rebuffi
Stefania
S
Fossa
Elena
E
Faronato
Pierpaolo
P
Spinella
Nello
N
Tessarin
Michele
M
Foscolo
Giancarlo
G
D000008:Abdominal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000328:Adult; D000367:Age Factors; D000368:Aged; D001774:Blood Chemical Analysis; D004750:Enteral Nutrition / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006701:Home Nursing; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000453:epidemiology; D015995:Prevalence; D012449:Safety; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000401:mortality / Q000473:pathology / Q000628:therapy