The Czech Home Parenteral Nutrition Registry REDNUP: Comprehensive Analysis of Adult Patients' Data.

INTRODUCTION: Home parenteral nutrition (HPN) is the primary treatment modality for patients with chronic intestinal failure, one of the least common organ failures. This article provides a retrospective analysis of the data collected on HPN patients in the Czech Republic over the past 30 years. METHODS: National registry data were collected using a standardised online form based on the OASIS registry (Oley - A.S.P.E.N. Information System) across all centres providing HPN in the Czech Republic. Data collected prospectively from adult patients in the HPN program were analysed in the following categories: epidemiology, demographics, underlying syndrome, diagnosis, complications, and teduglutide therapy prevalence. RESULTS: The registry identified a total of 1,838 adult patient records, reflecting almost 1.5 million individual catheter days. The prevalence of HPN has risen considerably over the last few decades, currently reaching 5.5 per 100,000 population. The majority of patients have short bowel syndrome and GI obstruction, with cancer being the most prevalent underlying disease. Catheter-related bloodstream infections have been the most prevalent acute complication. However, the incidence in 2022 was only 0.15 per 1,000 catheter days. The study also observed an increase in the prevalence of patients on palliative HPN over the last decade. CONCLUSION: This study presents a thorough analysis of data from the Czech REgistr Domaci NUtricni Podpory (REDNUP) registry. It shows an increasing prevalence of HPN, namely, in the palliative patient group. The sharing of national data can improve understanding of this rare condition and facilitate the development of international guidelines.

[Clinical experience in patients with intestinal failure: a cohort study in a third referral hospital]. / Experiencia clínica en pacientes con fallo intestinal: estudio de cohorte en un hospital de referencia.

Introduction: Introduction: intestinal failure (IF) is an organic failure classified into three types (I-III); it conditions inability to absorb nutrients and water, so parenteral nutrition (PN) is required. Objective: to evaluate the characteristics of hospitalized patients with IF, and their association with clinical and nutritional outcomes. Methods: historical cohort of hospitalized adults with IF and PN. Variables of the nutritional care process (screening, anthropometric, biochemical, clinical, nutritional), mortality and hospital stay were recorded. Results: six hundred and ninety-seven patients aged 56 (41-68) years, 327 women (46.8 %), with body mass index (BMI) 22.4 (18.3-25.9), were included. Diagnosis: 577 patients with IF-I, 96 patients with IF-II, and 24 patients with IF-III. The most frequent causes were malignant neoplasms, IF-I (26.7 %) and surgical complications in IF-II (21.9 %) and IF-III (37.5 %). The most common pathophysiology in all types of IF was motility disorders (40.6 % in IF-I; 43.8 % in IF-II; 33.8 % in IF-III). The majority of patients had high nutritional risk (92.4 %) and refeeding syndrome (65.6 % high and very high). In acute IF (FI-I) compared to prolonged IF (If-II/IF-III) there is a higher BMI (p = 0.039), visceral fat (p = 0.041) and over-hydration (p = 0.014), but they have a smaller phase angle (p = 0.004), with a lower adequacy percentage than what is prescribed in relation to their energy expenditure (p < 0.001). Conclusions: during the nutritional care process there are differences between the types of IF, which are relevant to optimize their multidisciplinary management and avoid related complications.

Introducción: Introducción: el fallo intestinal (FI) es un fallo orgánico clasificado en tres tipos (I-III). Condiciona incapacidad para absorber los nutrimentos y agua, por lo que se requiere nutrición parenteral (NP). Objetivo: evaluar las características de pacientes hospitalizados con FI y su asociación con desenlaces clínicos y nutricionales. Métodos: cohorte histórica de adultos hospitalizados con FI y NP. Se registraron variables del proceso de atención nutricia (tamizaje, antropométricas, bioquímicas, clínicas, nutricionales), mortalidad y estancia hospitalaria. Resultados: se incluyeron 697 pacientes, de 56 (41-68) años, 327 mujeres (46,8 %) e índice de masa corporal (IMC) 22,4 (18,3-25,9). Diagnóstico: 577 pacientes FI-I, 96 FI-II y 24 FI-III. Las causas más frecuentes fueron las neoplasias malignas en FI-I (26,7 %) y FI-II (21,9 %) y las complicaciones quirúrgicas en FI-III (37,5 %). La fisiopatología más común en todos los tipos de FI fue desórdenes de la motilidad (40,6 % en FI-I, 43,8 % en FI-II y 33,8 % en FI-III), con elevado riesgo nutricio (92,4 %) y de realimentación (65,6 % alto y muy alto). En el FI agudo (FI-I), en comparación con el prolongado (FI-II/FI-III), se tiene un mayor IMC (p = 0,039) y grasa visceral (p = 0,041) y están sobrehidratados (p = 0,014), pero cuentan con un menor ángulo de fase (p = 0,004) y tienen porcentaje de adecuación menor de lo que se prescribe en relación a su gasto energético (p < 0,001). Conclusiones: durante el proceso de atención nutricia existen diferencias entre los tipos de FI, que son relevantes para optimizar su manejo multidisciplinario y evitar las complicaciones relacionadas.