Use of home parenteral nutrition in patients with intra-abdominal desmoid tumors.
BACKGROUND
Fistulae, small bowel obstruction (SBO), and malabsorption are complications of intra-abdominal desmoid (IAD) tumors that require home parenteral nutrition (HPN). HPN outcomes in patients with IAD tumors have not been previously reported. The aim of this study was to compare some of the nutrition parameters and complications of HPN in patients with IAD with a control group of patients on HPN.


METHODS
This was a case-control study of patients and randomly selected controls who required HPN because of fistulae, SBO, or malabsorption and were managed by the Cleveland Clinic Nutrition Support Team between 1990 and 2008. Variables included demographics, indications, number of episodes, duration of HPN, number of admissions and complications related to HPN, and nutrition parameters. Univariable and multivariable logistic regression analyses were used.


RESULTS
Eighteen of 1615 HPN patients (1.1%) had IAD. For the study, 58 patients were included: 14 with IAD and 44 controls. Four IAD patients did not have complete medical records. IAD patients had longer duration of HPN (P = .015), were younger (P = .028), and were more likely to receive HPN for malabsorption (P < .001). Body mass index (BMI), serum albumin level, protein intake provided at the beginning of HPN, energy intake provided at the start and end of HPN, mortality, and complications were comparable between groups. At the end of HPN, IAD patients received significantly more protein and had lower serum albumin levels compared with controls.


CONCLUSIONS
HPN for IAD patients maintained BMI but did not increase serum albumin concentration despite receiving more protein than controls. IAD patients did not have increased HPN-related complications.
Shatnawei
Abdullah
A
Center of Human Nutrition-Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue A51, Cleveland, OH 44195, USA.
Hamilton
Cynthia
C
Quintini
Cristiano
C
Steiger
Ezra
E
Kirby
Donald F
DF
D000328:Adult; D000367:Age Factors; D000418:Albumins / Q000378:metabolism*; D015992:Body Mass Index; D016022:Case-Control Studies; D004044:Dietary Proteins / Q000008:administration & dosage; D018221:Fibromatosis, Abdominal / Q000150:complications*; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000628:therapy; D016015:Logistic Models; D008286:Malabsorption Syndromes / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000706:statistics & numerical data*; D012778:Short Bowel Syndrome / Q000209:etiology / Q000628:therapy; D013997:Time Factors
D000418:Albumins; D004044:Dietary Proteins