title: Outcomes of a general hospital-based home parenteral nutrition (HPN) program; report of our experience from a 26-year period.
abstract: BACKGROUND
  Home parenteral nutrition (HPN) was introduced in Spain in the late 1980s. Our hospital was a pioneering medical centre in this field.
  
  
  OBJECTIVE
  Analyze outcomes of our HPN program.
  
  
  METHODS
  Retrospective study of patients receiving HPN between 1986-2012. Study variables are expressed as frequency, mean ± SD (range), median [interquartile range]. Parametrics, non-parametrics test and survival analysis (p < 0.05) were applied.
  
  
  RESULTS
  91 patients (55 females and 36 males, mean age: 50.6 ± 5 yrs.) who received HPN for an accrual period of 55,470 days (median: 211 days [range: 63-573]) were included. The most prevalent underlying condition was cancer (49.5%), with the commonest HPN indication being short bowel syndrome (41.1%). The most frequently used catheter type was the tunneled catheter (70.7%). The complication rate was 3.58/1,000 HPN days (2.68, infection; 0.07, occlusion; 0.07 thrombosis; and 0.59, metabolic complications). Complications were consistently associated with both the underlying condition and HPN length. Infections were most frequent within the first 1,000 days of HPN. Liver disease incidence was related to HPN duration. HPN could be discontinued in 42.3% of patients. Ten-year survival rate was 42%, and varied across the underlying conditions.
  
  
  CONCLUSIONS
  In the present series, the commonest reason for HPN was cancer. Our complication rate is in keeping with that reported in the literature. The overall survival rate was 42%, and varied across the underlying conditions.
authors.affiliation: Unidad de Nutrición Clínica y Dietética. Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid. España.. ihiguera86@gmail.com.
authors.forename: Isabel
authors.initials: I
authors.lastname: Higuera
authors.affiliation: Unidad de Nutrición Clínica y Dietética. Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid. España.. pgarciap@salud.madrid.org.
authors.forename: Pilar
authors.initials: P
authors.lastname: Garcia-Peris
authors.affiliation: Unidad de Nutrición Clínica y Dietética. Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid. España.. mcamblor@salud.madrid.org.
authors.forename: Miguel
authors.initials: M
authors.lastname: Camblor
authors.affiliation: Unidad de Nutrición Clínica y Dietética. Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid. España.. ibreton@salud.madrid.org.
authors.forename: Irene
authors.initials: I
authors.lastname: Bretón
authors.affiliation: Unidad de Nutrición Clínica y Dietética. Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid. España.. cvelasco@salud.madrid.org.
authors.forename: Cristina
authors.initials: C
authors.lastname: Velasco
authors.affiliation: Servicio de Farmacia. Hospital General Universitario Gregorio Marañón. Madrid. España.. rromeroj@salud.madrid.org.
authors.forename: Rosa
authors.initials: R
authors.lastname: Romero
authors.affiliation: Unidad de Nutrición Clínica y Dietética. Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid. España.. lfrias@salud.madrid.org.
authors.forename: Laura
authors.initials: L
authors.lastname: Frias
authors.affiliation: Unidad de Nutrición Clínica y Dietética. Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid. España.. mcuerda@salud.madrid.org.
authors.forename: Cristina
authors.initials: C
authors.lastname: Cuerda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home; D015397:Program Evaluation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult