title: Catheter-related complications in long-term home parenteral nutrition patients with chronic intestinal failure.
abstract: BACKGROUND
  Home Parenteral Nutrition is a therapeutic option to improve quality of life in chronic intestinal failure.
  
  
  OBJECTIVE
  To describe frequency of complications both in cancer and noncancer patients.
  
  
  METHODS
  This study was performed on 270 adult patients (52% with cancer, 48% without cancer) followed for a total of 371 years of treatment. Mean duration of therapy was 191±181 for cancer and 830±1168 days/patient for noncancer. The treatment was administered by a competent, dedicated provider. Patients received our prescribed "all-in-one admixtures" at their homes.
  
  
  RESULTS
  Catheter-related complications/1000-days-catheter was 1.40; mechanical complications were comparable in cancer (0.82) and noncancer (0.91) patients while a statistically significant difference was observed between cancer (0.71) and noncancer (0.46) patients for sepsis. Bacterial infections were more frequent in noncancer, mycotic infections primarily affected cancer patients. In our experience 49% of the patients were readmitted, with a low incidence rate of 0.89/1000 days-catheter. The incidence of hepatobiliary complications in our population was 65%. The degree of liver damage was related to short bowel syndrome and to length of treatment.
  
  
  CONCLUSIONS
  This study indicated that cancer patients are more vulnerable to CVC-related infections during Home Parenteral Nutrition and that a safer Home Parenteral Nutrition protocol should be adopted in order to contain CVC-related complications.
authors.affiliation: Department of Gastroenterology & Artificial Nutrition, "San Nicola Pellegrino" Hospital - Trani (BT) - Italy.
authors.forename: Francesco William
authors.initials: FW
authors.lastname: Guglielmi
authors.forename: Nunzia
authors.initials: N
authors.lastname: Regano
authors.forename: Silvia
authors.initials: S
authors.lastname: Mazzuoli
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Rizzi
authors.forename: Simona
authors.initials: S
authors.lastname: Fregnan
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Leogrande
authors.forename: Irene
authors.initials: I
authors.lastname: Addante
authors.forename: Altomarino
authors.initials: A
authors.lastname: Guglielmi
mesh_terms: D000328:Adult; D000855:Anorexia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D016331:Parenteral Nutrition, Home / Q000009:adverse effects* / Q000295:instrumentation; D010359:Patient Readmission; D012307:Risk Factors; D012778:Short Bowel Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome