title: Intestinal failure-associated liver disease in hospitalised children.
abstract: OBJECTIVE
  Liver disease is a potentially life-threatening complication of intravenous/parenteral nutrition (PN). Our aim was to determine the incidence, aetiology and outcome of intestinal failure-associated liver disease (IFALD) in hospitalised children treated with long-term PN (>27 days).
  
  
  METHODS
  Over 4 years all long-term intestinal failure (IF) patients were reviewed for the possible predisposing factors of age, diagnosis, PN lipid, sepsis, length of PN treatment and length of hospitalisation. Outcome measures were IFALD incidence, severity and prognosis.
  
  
  RESULTS
  Of 60/279 (22%) children aged 0-18 years who developed IFALD, 13 (5%) progressed to type 3/end stage disease. IFALD was associated with younger age (p=0.03), longer treatment (p<0.001), longer hospitalisation (p=0.01), surgical diagnosis (p=0.005) and prematurity (p=0.03). IFALD was not associated with sepsis. Intestinal surgery was associated with IFALD independently of age (p=0.03). Survival was 86%, with three deaths attributed to IFALD (1% of all cases), all of which were surgical.
  
  
  CONCLUSIONS
  IFALD incidence was lower than previously reported in paediatric patients, with surgical neonates at greatest risk.
authors.affiliation: Department of Paediatric and Adolescent Medicine, University Clinic, Vienna, Austria.
authors.forename: Judith
authors.initials: J
authors.lastname: Pichler
authors.forename: Venetia
authors.initials: V
authors.lastname: Horn
authors.forename: Sarah
authors.initials: S
authors.lastname: Macdonald
authors.forename: Susan
authors.initials: S
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008107:Liver Diseases / Q000209:etiology*; D008111:Liver Function Tests / Q000379:methods; D008286:Malabsorption Syndromes / Q000150:complications* / Q000628:therapy; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects* / Q000379:methods; D011379:Prognosis; D012720:Severity of Illness Index