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2. COVID-19 infection in patients on long-term home parenteral nutrition for chronic intestinal failure

Author

Pironi, L, Jezerski, D, Sobocki, J, Lal, S, Vanuytsel, T, Theilla, M, Sasdelli, A, Chambrier, C, Matysiak, K, Aimasso, U, Rasmussen, H, Jukes, A, Kunecki, M, Seguy, D, Schneider, S, Daniels, J, Poullenot, F, Mundi, M, Matras, P, Folwarski, M, Crivelli, A, Wyer, N, Ellegard, L, Santarpia, L, Arvanitakis, M, Spaggiari, C, Lamprecht, G, Guglielmi, F, Lezo, A, Layec, S, Boluda, E, Guz-Mark, A, Gandullia, P, Cuerda, C, Osland, E, Spagnuolo, M, Krznaric, Z, Masconale, L, Chapman, B, Maiz-Jimenez, M, Orlandoni, P, Martins da Rocha, M, Virgili-Casas, M, Doitchinova-Simeonova, M, Czako, L, Van Gossum, A, D'Antiga, L, Ee, L, Warodomwichit, D, Taus, M, Kolacek, S, Thibault, R, Verlato, G, Serralde-Zuniga, A, Botella-Carretero, J, Aguayo, P, Olveira, G, Chomtho, S, Pisprasert, V, Moisejevs, G, Murillo, A, Jauregui, M, Diez, M, Jahit, M, Densupsoontorn, N, Tamer, A, Brillanti, G, Joly, F, Pironi L., Jezerski D., Sobocki J., Lal S., Vanuytsel T., Theilla M., Sasdelli A. S., Chambrier C., Matysiak K., Aimasso U., Rasmussen H. H., Jukes A., Kunecki M., Seguy D., Schneider S. M., Daniels J., Poullenot F., Mundi M. S., Matras P., Folwarski M., Crivelli A., Wyer N., Ellegard L., Santarpia L., Arvanitakis M., Spaggiari C., Lamprecht G., Guglielmi F. W., Lezo A., Layec S., Boluda E. R., Guz-Mark A., Gandullia P., Cuerda C., Osland E., Spagnuolo M. I., Krznaric Z., Masconale L., Chapman B., Maiz-Jimenez M., Orlandoni P., Martins da Rocha M. H., Virgili-Casas M. N., Doitchinova-Simeonova M., Czako L., Van Gossum A., D'Antiga L., Ee L. C., Warodomwichit D., Taus M., Kolacek S., Thibault R., Verlato G., Serralde-Zuniga A. E., Botella-Carretero J. I., Aguayo P. S., Olveira G., Chomtho S., Pisprasert V., Moisejevs G., Murillo A. Z., Jauregui M. E. P., Diez M. B., Jahit M. S., Densupsoontorn N., Tamer A., Brillanti G., Joly F., Pironi, L, Jezerski, D, Sobocki, J, Lal, S, Vanuytsel, T, Theilla, M, Sasdelli, A, Chambrier, C, Matysiak, K, Aimasso, U, Rasmussen, H, Jukes, A, Kunecki, M, Seguy, D, Schneider, S, Daniels, J, Poullenot, F, Mundi, M, Matras, P, Folwarski, M, Crivelli, A, Wyer, N, Ellegard, L, Santarpia, L, Arvanitakis, M, Spaggiari, C, Lamprecht, G, Guglielmi, F, Lezo, A, Layec, S, Boluda, E, Guz-Mark, A, Gandullia, P, Cuerda, C, Osland, E, Spagnuolo, M, Krznaric, Z, Masconale, L, Chapman, B, Maiz-Jimenez, M, Orlandoni, P, Martins da Rocha, M, Virgili-Casas, M, Doitchinova-Simeonova, M, Czako, L, Van Gossum, A, D'Antiga, L, Ee, L, Warodomwichit, D, Taus, M, Kolacek, S, Thibault, R, Verlato, G, Serralde-Zuniga, A, Botella-Carretero, J, Aguayo, P, Olveira, G, Chomtho, S, Pisprasert, V, Moisejevs, G, Murillo, A, Jauregui, M, Diez, M, Jahit, M, Densupsoontorn, N, Tamer, A, Brillanti, G, Joly, F, Pironi L., Jezerski D., Sobocki J., Lal S., Vanuytsel T., Theilla M., Sasdelli A. S., Chambrier C., Matysiak K., Aimasso U., Rasmussen H. H., Jukes A., Kunecki M., Seguy D., Schneider S. M., Daniels J., Poullenot F., Mundi M. S., Matras P., Folwarski M., Crivelli A., Wyer N., Ellegard L., Santarpia L., Arvanitakis M., Spaggiari C., Lamprecht G., Guglielmi F. W., Lezo A., Layec S., Boluda E. R., Guz-Mark A., Gandullia P., Cuerda C., Osland E., Spagnuolo M. I., Krznaric Z., Masconale L., Chapman B., Maiz-Jimenez M., Orlandoni P., Martins da Rocha M. H., Virgili-Casas M. N., Doitchinova-Simeonova M., Czako L., Van Gossum A., D'Antiga L., Ee L. C., Warodomwichit D., Taus M., Kolacek S., Thibault R., Verlato G., Serralde-Zuniga A. E., Botella-Carretero J. I., Aguayo P. S., Olveira G., Chomtho S., Pisprasert V., Moisejevs G., Murillo A. Z., Jauregui M. E. P., Diez M. B., Jahit M. S., Densupsoontorn N., Tamer A., Brillanti G., and Joly F.

Abstract

Background and aims: To investigate the incidence and the severity of COVID-19 infection in patients enrolled in the database for home parenteral nutrition (HPN) for chronic intestinal failure (CIF) of the European Society for Clinical Nutrition and Metabolism (ESPEN). Methods: Period of observation: March 1st, 2020 March 1st, 2021. Inclusion criteria: patients included in the database since 2015 and still receiving HPN on March 1st, 2020 as well as new patients included in the database during the period of observation. Data related to the previous 12 months and recorded on March 1st 2021: 1) occurrence of COVID-19 infection since the beginning of the pandemic (yes, no, unknown); 2) infection severity (asymptomatic; mild, no-hospitalization; moderate, hospitalization no-ICU; severe, hospitalization in ICU); 3) vaccinated against COVID-19 (yes, no, unknown); 4) patient outcome on March 1st 2021: still on HPN, weaned off HPN, deceased, lost to follow up. Results: Sixty-eight centres from 23 countries included 4680 patients. Data on COVID-19 were available for 55.1% of patients. The cumulative incidence of infection was 9.6% in the total group and ranged from 0% to 21.9% in the cohorts of individual countries. Infection severity was reported as: asymptomatic 26.7%, mild 32.0%, moderate 36.0%, severe 5.3%. Vaccination status was unknown in 62.0% of patients, non-vaccinated 25.2%, vaccinated 12.8%. Patient outcome was reported as: still on HPN 78.6%, weaned off HPN 10.6%, deceased 9.7%, lost to follow up 1.1%. A higher incidence of infection (p = 0.04), greater severity of infection (p < 0.001) and a lower vaccination percentage (p = 0.01) were observed in deceased patients. In COVID-19 infected patients, deaths due to infection accounted for 42.8% of total deaths. Conclusions: In patients on HPN for CIF, the incidence of COVID-19 infection differed greatly among countries. Although the majority of cases were reported to be asymptomatic or have mild symptoms only, COV

Published
2023

3. Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey

Author

Lezo, A, Diamanti, A, Marinier, E, Tabbers, M, Guz-Mark, A, Gandullia, P, Spagnuolo, M, Protheroe, S, Peretti, N, Merras-Salmio, L, Hulst, J, Kolacek, S, Ee, L, Lawrence, J, Hind, J, D'Antiga, L, Verlato, G, Pukite, I, Di Leo, G, Vanuytsel, T, Doitchinova-Simeonova, M, Ellegard, L, Masconale, L, Maiz-Jimenez, M, Cooper, S, Brillanti, G, Nardi, E, Sasdelli, A, Lal, S, Pironi, L, Lezo A., Diamanti A., Marinier E. M., Tabbers M., Guz-Mark A., Gandullia P., Spagnuolo M. I., Protheroe S., Peretti N., Merras-Salmio L., Hulst J. M., Kolacek S., Ee L. C., Lawrence J., Hind J., D'antiga L., Verlato G., Pukite I., Di Leo G., Vanuytsel T., Doitchinova-Simeonova M. K., Ellegard L., Masconale L., Maiz-Jimenez M., Cooper S. C., Brillanti G., Nardi E., Sasdelli A. S., Lal S., Pironi L., Lezo, A, Diamanti, A, Marinier, E, Tabbers, M, Guz-Mark, A, Gandullia, P, Spagnuolo, M, Protheroe, S, Peretti, N, Merras-Salmio, L, Hulst, J, Kolacek, S, Ee, L, Lawrence, J, Hind, J, D'Antiga, L, Verlato, G, Pukite, I, Di Leo, G, Vanuytsel, T, Doitchinova-Simeonova, M, Ellegard, L, Masconale, L, Maiz-Jimenez, M, Cooper, S, Brillanti, G, Nardi, E, Sasdelli, A, Lal, S, Pironi, L, Lezo A., Diamanti A., Marinier E. M., Tabbers M., Guz-Mark A., Gandullia P., Spagnuolo M. I., Protheroe S., Peretti N., Merras-Salmio L., Hulst J. M., Kolacek S., Ee L. C., Lawrence J., Hind J., D'antiga L., Verlato G., Pukite I., Di Leo G., Vanuytsel T., Doitchinova-Simeonova M. K., Ellegard L., Masconale L., Maiz-Jimenez M., Cooper S. C., Brillanti G., Nardi E., Sasdelli A. S., Lal S., and Pironi L.

Abstract

Background: The European Society for Clinical Nutrition and Metabolism database for chronic intestinal failure (CIF) was analyzed to investigate factors associated with nutritional status and the intravenous supplementation (IVS) dependency in children. Methods: Data collected: demographics, CIF mechanism, home parenteral nutrition program, z-scores of weight-for-age (WFA), length or height-for-age (LFA/HFA), and body mass index-for-age (BMI-FA). IVS dependency was calculated as the ratio of daily total IVS energy over estimated resting energy expenditure (%IVSE/REE). Results: Five hundred and fifty-eight patients were included, 57.2% of whom were male. CIF mechanisms at age 1–4 and 14–18 years, respectively: SBS 63.3%, 37.9%; dysmotility or mucosal disease: 36.7%, 62.1%. One-third had WFA and/or LFA/HFA z-scores < −2. One-third had %IVSE/REE > 125%. Multivariate analysis showed that mechanism of CIF was associated with WFA and/or LFA/HFA z-scores (negatively with mucosal disease) and %IVSE/REE (higher for dysmotility and lower in SBS with colon in continuity), while z-scores were negatively associated with %IVSE/REE. Conclusions: The main mechanism of CIF at young age was short bowel syndrome (SBS), whereas most patients facing adulthood had intestinal dysmotility or mucosal disease. One-third were underweight or stunted and had high IVS dependency. Considering that IVS dependency was associated with both CIF mechanisms and nutritional status, IVS dependency is suggested as a potential marker for CIF severity in children.

Published
2022

5. Steroid biomarkers for identifying non-classic adrenal hyperplasia due to 21-hydroxylase deficiency in a population of PCOS with suspicious levels of 17OH-progesterone

Author

Oriolo, C., Fanelli, F., Castelli, S., Mezzullo, M., Altieri, P., Corzani, F., Pelusi, C., Repaci, A., Di Dalmazi, G., Vicennati, V., Baldazzi, L., Menabò, S., Dormi, A., Nardi, E., Brillanti, G., Pasquali, R., Pagotto, U., and Gambineri, A.

Abstract

Objective: We aimed at defining the most effective routine immunoassay- or liquid chromatography-tandem mass spectrometry (LC–MS/MS)-determined steroid biomarkers for identifying non-classic adrenal hyperplasia due to 21-hydroxylase deficiency (21-NCAH) in a PCOS-like population before genotyping. Methods: Seventy PCOS-like patients in reproductive age with immunoassay-determined follicular 17OH-progesterone (17OHP) ≥ 2.00 ng/mL underwent CYP21A2gene analysis and 1–24ACTH test. Serum steroids were measured by immunoassays at baseline and 60 min after ACTH stimulation; basal steroid profile was measured by LC–MS/MS. Results: Genotyping revealed 23 21-NCAH, 15 single allele heterozygous CYP21A2mutations (21-HTZ) and 32 PCOS patients displaying similar clinical and metabolic features. Immunoassays revealed higher baseline 17OHP and testosterone, and after ACTH stimulation, higher 17OHP (17OHP60) and lower cortisol, whereas LC–MS/MS revealed higher 17OHP (17OHPLC-MS/MS), progesterone and 21-deoxycortisol and lower corticosterone in 21-NCAH compared with both 21-HTZ and PCOS patients. Steroid thresholds best discriminating 21-NCAH from 21-HTZ and PCOS were estimated, and their diagnostic accuracy in identifying 21-NCAH from PCOS was established by ROC analysis. The highest accuracy was observed for 21-deoxycortisol ≥ 0.087 ng/mL, showing 100% sensitivity, while the combination of 17OHPLC-MS/MS≥ 1.79 ng/mL and corticosterone ≤ 8.76 ng/mL, as well as the combination of ACTH-stimulated 17OHP ≥ 6.77 ng/mL and cortisol ≤ 240 ng/mL by immunoassay, showed 100% specificity. Conclusions: LC–MS/MS measurement of basal follicular 21-deoxycortisol, 17OHP and corticosterone seems the most convenient method for diagnosing 21-NCAH in a population of PCOS with a positive first level screening, providing high accuracy and reducing the need for ACTH stimulation test.

Published
2024
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6. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey

Author

Pironi, L, Steiger, E., Joly, F., Jeppesen, P.B., Wanten, G.J.A., Sasdelli, A.S., Chambrier, C., Aimasso, U., Mundi, M.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Santarpia, L., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Ellegard, L., Thibault, R., Matras, P., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Udvarhelyi, G., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Spaggiari, C., Díez, M.B., Doitchinova-Simeonova, M., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, M.E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Youssef, N.N., Brillanti, G., Nardi, E., Lal, S., Pironi, L, Steiger, E., Joly, F., Jeppesen, P.B., Wanten, G.J.A., Sasdelli, A.S., Chambrier, C., Aimasso, U., Mundi, M.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Santarpia, L., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Ellegard, L., Thibault, R., Matras, P., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Udvarhelyi, G., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Spaggiari, C., Díez, M.B., Doitchinova-Simeonova, M., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, M.E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Youssef, N.N., Brillanti, G., Nardi, E., and Lal, S.

Abstract

Item does not contain fulltext, BACKGROUND AND AIMS: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as <1, 1-2, 2-3 and >3 L/day. RESULTS: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.

Published
2021

7. Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey

Author

Antonella Lezo, Antonella Diamanti, Evelyne M. Marinier, Merit Tabbers, Anat Guz-Mark, Paolo Gandullia, Maria I. Spagnuolo, Sue Protheroe, Noel Peretti, Laura Merras-Salmio, Jessie M. Hulst, Sanja Kolaček, Looi C. Ee, Joanna Lawrence, Jonathan Hind, Lorenzo D’Antiga, Giovanna Verlato, Ieva Pukite, Grazia Di Leo, Tim Vanuytsel, Maryana K. Doitchinova-Simeonova, Lars Ellegard, Luisa Masconale, María Maíz-Jiménez, Sheldon C. Cooper, Giorgia Brillanti, Elena Nardi, Anna S. Sasdelli, Simon Lal, Loris Pironi, Regione Piemonte Azienda Ospedaliera - S. Anna [Turin, Italy] (OIRM-S), Ospedale Bambin Gesù [Rome, Italy] (OBG), Centre de Référence des Maladies Digestives Rares [AP-HP Hôpital Robert-Debré] (CRMDR), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Emma Children’s Hospital, Amsterdam UMC - Amsterdam University Medical Center, Schneider Children’s Medical Center [Petah Tikva, Israel] (SCMC), Tel Aviv University (TAU), IRCCS Istituto Giannina Gaslini [Genoa, Italy], University of Naples Federico II = Università degli studi di Napoli Federico II, Birmingham Women's and Children's NHS Foundation Trust, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Helsinki University Hospital [Finland] (HUS), Eramus MC-Sophia Children’s Hospital, Partenaires INRAE, Children’s Hospital Srebrnjak [Zagreb, Croatia], Children’s Health Queensland [Brisbane] (CHQ), Royal Children’s Hospital & Department of Paediatrics [Parkville, VIC, Australia], King‘s College London, Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Azienda Ospedale Università di Padova = Hospital-University of Padua (AOUP), Children's Clinical University Hospital [Riga, Latvia] (CCUH), Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo' [Trieste], Leuven Intestinal Failure and Transplantation [Leuven, Belgium] (LIFT), University Hospitals Leuven [Leuven], Bulgarian Association of Patients with Malnutrition [Sofia, Bulgaria] (BAPM), Sahlgrenska University Hospital [Gothenburg], Ospedale Orlandi [Bussolengo, Italy] (2O), Hospital Universitario 12 de Octubre [Madrid], Alma Mater Studiorum University of Bologna (UNIBO), University of Bologna/Università di Bologna, Azienda Ospedaliero-Universitaria di Bologna [Bolohna, Italy] (AOUB), Salford Royal NHS Foundation Trust [Salford, UK], CarMeN, laboratoire, Pediatrics, Pediatric surgery, Clinicum, HUS Children and Adolescents, Children's Hospital, University of Helsinki, Paediatric Gastroenterology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, ARD - Amsterdam Reproduction and Development, Lezo A., Diamanti A., Marinier E.M., Tabbers M., Guz-Mark A., Gandullia P., Spagnuolo M.I., Protheroe S., Peretti N., Merras-Salmio L., Hulst J.M., Kolacek S., Ee L.C., Lawrence J., Hind J., D'antiga L., Verlato G., Pukite I., Di Leo G., Vanuytsel T., Doitchinova-Simeonova M.K., Ellegard L., Masconale L., Maiz-Jimenez M., Cooper S.C., Brillanti G., Nardi E., Sasdelli A.S., Lal S., Pironi L., Lezo, Antonella, Diamanti, Antonella, Marinier, Evelyne M., Tabbers, Merit, Guz-Mark, Anat, Gandullia, Paolo, Spagnuolo, Maria I., Protheroe, Sue, Peretti, Noel, Merras-Salmio, Laura, Hulst, Jessie M., Kola( (c))ek, Sanja, Ee, Looi C., Lawrence, Joanna, Hind, Jonathan, D'Antiga, Lorenzo, Verlato, Giovanna, Pukite, Ieva, Di Leo, Grazia, Vanuytsel, Tim, Doitchinova-Simeonova, Maryana K., Ellegard, Lar, Masconale, Luisa, Ma('(i))z-Jim('(e))nez, Mar('(i))a, Cooper, Sheldon C., Brillanti, Giorgia, Nardi, Elena, Sasdelli, Anna S., Lal, Simon, and Pironi, Loris

Subjects
Adult, Male, Short Bowel Syndrome, [SDV]Life Sciences [q-bio], YOUNG-PEOPLE, ENTERAL NUTRITION, CLASSIFICATION, home parenteral nutrition, Intestinal Failure, children, body growth, Humans, chronic intestinal failure, intravenous supplementation, intestinal transplantation, transition, ADULT PATIENTS, HEPATOLOGY, Child, Cross-Sectional Studie, Nutrition and Dietetics, Science & Technology, Intestinal Disease, Nutrition & Dietetics, GASTROENTEROLOGY, PREVALENCE, [SDV] Life Sciences [q-bio], Intestinal Diseases, Cross-Sectional Studies, ITALIAN SOCIETY, Chronic Disease, HOME PARENTERAL-NUTRITION, Female, REHABILITATION PROGRAMS, 3143 Nutrition, Parenteral Nutrition, Home, Life Sciences & Biomedicine, Food Science, Human
Abstract

Background: The European Society for Clinical Nutrition and Metabolism database for chronic intestinal failure (CIF) was analyzed to investigate factors associated with nutritional status and the intravenous supplementation (IVS) dependency in children. Methods: Data collected: demographics, CIF mechanism, home parenteral nutrition program, z-scores of weight-for-age (WFA), length or height-for-age (LFA/HFA), and body mass index-for-age (BMI-FA). IVS dependency was calculated as the ratio of daily total IVS energy over estimated resting energy expenditure (%IVSE/REE). Results: Five hundred and fifty-eight patients were included, 57.2% of whom were male. CIF mechanisms at age 1−4 and 14−18 years, respectively: SBS 63.3%, 37.9%; dysmotility or mucosal disease: 36.7%, 62.1%. One-third had WFA and/or LFA/HFA z-scores < −2. One-third had %IVSE/REE > 125%. Multivariate analysis showed that mechanism of CIF was associated with WFA and/or LFA/HFA z-scores (negatively with mucosal disease) and %IVSE/REE (higher for dysmotility and lower in SBS with colon in continuity), while z-scores were negatively associated with %IVSE/REE. Conclusions: The main mechanism of CIF at young age was short bowel syndrome (SBS), whereas most patients facing adulthood had intestinal dysmotility or mucosal disease. One-third were underweight or stunted and had high IVS dependency. Considering that IVS dependency was associated with both CIF mechanisms and nutritional status, IVS dependency is suggested as a potential marker for CIF severity in children. ispartof: NUTRIENTS vol:14 issue:9 ispartof: location:Switzerland status: published

Published
2022
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8. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome:An international multicenter survey

Author

Loris Pironi, Ezra Steiger, Francisca Joly, Palle B. Jeppesen, Geert Wanten, Anna S. Sasdelli, Cecile Chambrier, Umberto Aimasso, Manpreet S. Mundi, Kinga Szczepanek, Amelia Jukes, Miriam Theilla, Marek Kunecki, Joanne Daniels, Mireille Serlie, Florian Poullenot, Sheldon C. Cooper, Henrik H. Rasmussen, Charlene Compher, David Seguy, Adriana Crivelli, Lidia Santarpia, Francesco W. Guglielmi, Nada Rotovnik Kozjek, Stéphane M. Schneider, Lars Ellegard, Ronan Thibault, Przemysław Matras, Konrad Matysiak, Andrè Van Gossum, Alastair Forbes, Nicola Wyer, Marina Taus, Nuria M. Virgili, Margie O'Callaghan, Brooke Chapman, Emma Osland, Cristina Cuerda, Gábor Udvarhelyi, Lynn Jones, Andre D. Won Lee, Luisa Masconale, Paolo Orlandoni, Corrado Spaggiari, Marta Bueno Díez, Maryana Doitchinova-Simeonova, Aurora E. Serralde-Zúñiga, Gabriel Olveira, Zeljko Krznaric, Laszlo Czako, Gintautas Kekstas, Alejandro Sanz-Paris, Mª Estrella Petrina Jáuregui, Ana Zugasti Murillo, Eszter Schafer, Jann Arends, José P. Suárez-Llanos, Nader N. Youssef, Giorgia Brillanti, Elena Nardi, Simon Lal, Adriana N. Crivelli, Hector Solar Muñiz, Brooke R. Chapman, Ruth Hodgson, Siobhan Wallin, Kay Lasenby, Andre Van Gossum, Andre Dong Won Lee, Henrik Højgaard Rasmussen, Chrisoffer Brandt, Vanessa Boehm, Julie Bataille, Lore Billiauws, Tomas Molnar, Mihaly Zsilak-Urban, Ferenc Izbéki, Peter Sahin, Anna Simona Sasdelli, Merlo F. Dario, Valentino Bertasi, Nunzia Regano, Santarpia Lidia, Lucia Alfonsi, Debora Busni, Lyn Gillanders, Anna Zmarzly, Marta Bueno, Carmen Garde, Ma Estrella Petrina Jáuregui, Cora Jonker, Simona Di Caro, Niamh Keane, Pinal Patel, Sarah-Jane Nelson Hughes, Rachel Lloyd, Arun Abraham, Gerda Garside, Michael Taylor, Jian Wu, Trevor Smith, Charlotte Pither, Michael Stroud, Reena Parmar, Nicola Burch, Sarah Zeraschi, Manpreet Mundi, Denise Jezerski, Pironi L., Steiger E., Joly F., Jeppesen P.B., Wanten G., Sasdelli A.S., Chambrier C., Aimasso U., Mundi M.M., Szczepanek K., Jukes A., Theilla M., Kunecki M., Daniels J., Serlie M., Poullenot F., Cooper S.C., Rasmussen H.H., Compher C., Seguy D., Crivelli A., Santarpia L., Guglielmi F.W., Kozjek N.R., Schneider S.M., Ellegard L., Thibault R., Matras P., Matysiak K., Van Gossum A., Forbes A., Wyer N., Taus M., Virgili N.M., O'Callaghan M., Chapman B., Osland E., Cuerda C., Udvarhelyi G., Jones L., Won Lee A.D., Masconale L., Orlandoni P., Spaggiari C., Diez M.B., Doitchinova-Simeonova M., Serralde-Zuniga A.E., Olveira G., Krznaric Z., Czako L., Kekstas G., Sanz-Paris A., Jauregui M.E.P., Murillo A.Z., Schafer E., Arends J., Suarez-Llanos J.P., Youssef N.N., Brillanti G., Nardi E., Lal S., Crivelli A.N., Muniz H.S., Chapman B.R., Hodgson R., Wallin S., Lasenby K., Brandt C., Boehm V., Bataille J., Billiauws L., Molnar T., Zsilak-Urban M., Izbeki F., Sahin P., Dario M.F., Bertasi V., Regano N., Lidia S., Alfonsi L., Busni D., Gillanders L., Zmarzly A., Bueno M., Garde C., Jonker C., Di Caro S., Keane N., Patel P., Nelson Hughes S.-J., Lloyd R., Abraham A., Garside G., Taylor M., Wu J., Smith T., Pither C., Stroud M., Parmar R., Burch N., Zeraschi S., Mundi M., Jezerski D., Endocrinology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, University of Bologna, Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Cleveland Clinic, Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Rigshospitalet [Copenhagen], Copenhagen University Hospital, Radboud University Medical Center [Nijmegen], Hospices Civils de Lyon (HCL), Città della Salute e della Scienza University-Hospital, Mayo Clinic and Mayo College of Medicine, Rochester, Stanley Dudrick's Memorial Hospital, Partenaires INRAE, University Hospital of Wales, Tel Aviv University [Tel Aviv], University of Lódź, Nottingham University Hospitals NHS Trust [UK], VU University Medical Center [Amsterdam], CHU Bordeaux [Bordeaux], University Hospitals Birmingham NHS Foundation Trust, Aalborg University Hospital, Hospital of the University of Pennsylvania (HUP), Perelman School of Medicine, University of Pennsylvania [Philadelphia]-University of Pennsylvania [Philadelphia], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hospital Universitario Fundacion Favaloro, University of Naples Federico II, Monsignor di Miccoli Hospital, Institute of Oncology - Ljubljana, Institute of Oncology Ljubljana, Centre Hospitalier Universitaire de Nice (CHU Nice), University of Gothenburg (GU), The project of the ESPEN database for Chronic Intestinal Failure was promoted by the ESPEN Executive Committee in 2013, was approved by the ESPEN Council and was supported by an ESPEN grant., University of Bologna/Università di Bologna, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University Hospital of Wales (UHW), Tel Aviv University (TAU), Nottingham University Hospitals NHS Trust (NUH), University of Pennsylvania-University of Pennsylvania, University of Naples Federico II = Università degli studi di Napoli Federico II, and Institute of Oncology [Ljubljana]

Subjects
Parenteral Nutrition, Epidemiology, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, MESH: Intestinal Diseases, Malalties intestinals, 0302 clinical medicine, Indicadors de salut, Medicine, 030212 general & internal medicine, Intestines--Diseases, Nutrition and Dietetics, Intestinal Disease, Short bowel syndrome, Intestinal failure, Health status indicators, 3. Good health, Chronic intestinal failure, Intestine, Intestines, medicine.anatomical_structure, Cohort, 030211 gastroenterology & hepatology, Female, MESH: Intestines, Human, Adult, Short Bowel Syndrome, medicine.medical_specialty, Anastomosis, 03 medical and health sciences, Ileocecal valve, MESH: Cross-Sectional Studies, epidemiology, home parenteral nutrition, intestinal failure, intravenous supplementation, short bowel syndrome, Internal medicine, MESH: Short Bowel Syndrome, Humans, Cross-Sectional Studie, Home parenteral nutrition, MESH: Humans, business.industry, MESH: Adult, medicine.disease, Intravenous supplementation, Intestinal Diseases, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Parenteral nutrition, Cross-Sectional Studies, Jejunostomy, business, MESH: Female, MESH: Parenteral Nutrition
Abstract

Contains fulltext : 244566.pdf (Publisher’s version ) (Closed access) BACKGROUND AND AIMS: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as 3 L/day. RESULTS: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.

Published
2021
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9. Steroid biomarkers for identifying non-classic adrenal hyperplasia due to 21-hydroxylase deficiency in a population of PCOS with suspicious levels of 17OH-progesterone

Author

S Castelli, Flaminia Fanelli, G. Di Dalmazi, Alessandra Gambineri, Valentina Vicennati, Lilia Baldazzi, G Brillanti, Uberto Pagotto, Andrea Repaci, Paola Altieri, Soara Menabo, C. Pelusi, Renato Pasquali, Marco Mezzullo, Elena Nardi, A Dormi, Francesca Corzani, Claudia Oriolo, Oriolo C., Fanelli F., Castelli S., Mezzullo M., Altieri P., Corzani F., Pelusi C., Repaci A., Di Dalmazi G., Vicennati V., Baldazzi L., Menabo S., Dormi A., Nardi E., Brillanti G., Pasquali R., Pagotto U., and Gambineri A.

Subjects
Adult, medicine.medical_specialty, Adolescent, Genotyping Techniques, Endocrinology, Diabetes and Metabolism, Population, DNA Mutational Analysis, Steroid profiling, CYP21A2 genotyping, ACTH test, Cohort Studies, Diagnostic Techniques, Endocrine, Basal (phylogenetics), chemistry.chemical_compound, Young Adult, Endocrinology, Corticosterone, Tandem Mass Spectrometry, Internal medicine, Follicular phase, Medicine, Humans, Testosterone, education, education.field_of_study, medicine.diagnostic_test, biology, Adrenal Hyperplasia, Congenital, business.industry, 17-alpha-Hydroxyprogesterone, ACTH stimulation test, 21-Hydroxylase, Reproducibility of Results, Hyperplasia, Non-classic adrenal hyperplasia due to 21-hydroxylase deficiency, medicine.disease, 1–24, chemistry, biology.protein, Female, Steroids, Steroid 21-Hydroxylase, business, Biomarkers, Blood Chemical Analysis, Chromatography, Liquid, Polycystic Ovary Syndrome
Abstract

Objective: We aimed at defining the most effective routine immunoassay- or liquid chromatography-tandem mass spectrometry (LC–MS/MS)-determined steroid biomarkers for identifying non-classic adrenal hyperplasia due to 21-hydroxylase deficiency (21-NCAH) in a PCOS-like population before genotyping. Methods: Seventy PCOS-like patients in reproductive age with immunoassay-determined follicular 17OH-progesterone (17OHP) ≥ 2.00 ng/mL underwent CYP21A2 gene analysis and 1–24ACTH test. Serum steroids were measured by immunoassays at baseline and 60 min after ACTH stimulation; basal steroid profile was measured by LC–MS/MS. Results: Genotyping revealed 23 21-NCAH, 15 single allele heterozygous CYP21A2 mutations (21-HTZ) and 32 PCOS patients displaying similar clinical and metabolic features. Immunoassays revealed higher baseline 17OHP and testosterone, and after ACTH stimulation, higher 17OHP (17OHP60) and lower cortisol, whereas LC–MS/MS revealed higher 17OHP (17OHPLC-MS/MS), progesterone and 21-deoxycortisol and lower corticosterone in 21-NCAH compared with both 21-HTZ and PCOS patients. Steroid thresholds best discriminating 21-NCAH from 21-HTZ and PCOS were estimated, and their diagnostic accuracy in identifying 21-NCAH from PCOS was established by ROC analysis. The highest accuracy was observed for 21-deoxycortisol ≥ 0.087 ng/mL, showing 100% sensitivity, while the combination of 17OHPLC-MS/MS ≥ 1.79 ng/mL and corticosterone ≤ 8.76 ng/mL, as well as the combination of ACTH-stimulated 17OHP ≥ 6.77 ng/mL and cortisol ≤ 240 ng/mL by immunoassay, showed 100% specificity. Conclusions: LC–MS/MS measurement of basal follicular 21-deoxycortisol, 17OHP and corticosterone seems the most convenient method for diagnosing 21-NCAH in a population of PCOS with a positive first level screening, providing high accuracy and reducing the need for ACTH stimulation test.

Published
2019

10. Reoperations on the ascending aorta and aortic arch: A retrospective series of 453 patients.

Author

Di Marco L, Gliozzi G, Votano D, Murana G, Leone A, Cavalli GG, Brillanti G, and Pacini D

Subjects
Humans, Female, Aorta, Thoracic diagnostic imaging, Aorta, Thoracic surgery, Retrospective Studies, Reoperation, Treatment Outcome, Risk Factors, Aneurysm, False surgery, Blood Vessel Prosthesis Implantation, Aortic Dissection surgery, Aneurysm surgery, Endocarditis surgery, Aortic Aneurysm, Thoracic diagnostic imaging, Aortic Aneurysm, Thoracic surgery, Aortic Aneurysm, Thoracic etiology
Abstract

Objective: The study objective was to analyze the outcomes of reoperative thoracic aortic surgery at our institution from January 1986 to December 2018 to identify specific risk factors for early and late mortality., Methods: Two groups of patients were identified: aortic root or ascending aorta repair (group 1: proximal repair, 218 patients, 48%) and arch surgery or descending thoracic aorta repair (group 2: distal repair, 235 patients, 52%). Primary end points were 30-day mortality, 10-year survival, and freedom from aortic reoperations., Results: The 30-day mortality (6.4% vs 8.1%) and in-hospital mortality (8.3% vs 11.9%) were similar (P > .05) in the 2 groups. Multivariable analysis identified female gender (odds ratio, 8.60, P < .01), endocarditis (odds ratio, 2.96, P = .04), and cardiopulmonary bypass time (odds ratio, 1.02, P < .01) as risk factors for 30-day mortality. Mean follow-up time was 163 months (confidence interval, 147-179). Long-term survival at 1, 5, and 10 years was 91.2%, 79.4%, and 66.3% in the proximal repair group and 80.7%, 68.8%, the and 55.3% in distal repair group, respectively (P = .03). According to the indication, 1-, 5-, and 10-year survivals were 92.1%, 82.3%, and 68.8% in degenerative aneurysms; 82.7%, 72.4%, and 56.3% in residual dissections; 80.9%, 65.4%, and 50.3% in endocarditis and pseudoaneurysms; 69.2%, 52.7%, and 42.2% in acute type A aortic dissections, respectively (P < .01). Competing risk analysis showed a significantly different cumulative incidence of reoperation at 1, 5, and 10 years between the 2 groups: 0.50%, 0.50%, and 0.90%, respectively, for the proximal repair group, and 0.40%, 4.30%, and 7.70%, respectively, the for distal repair group (P < .01)., Conclusions: In our experience, short- and long-term results of reoperative thoracic aortic surgery were satisfactory in chronic aneurysms but poor in aortic dissections, pseudoaneurysms, and active endocarditis. Reoperative aortic surgery carries a high risk, regardless of the anatomic extension of the procedure., (Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2024
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11. Elective aortic arch surgery: cerebral perfusion flows and transient neurological dysfunctions.

Author

Berardi M, Di Marco L, Leone A, Coppola G, Gliozzi G, Zanzico F, Brillanti G, and Pacini D

Subjects
Female, Humans, Perfusion adverse effects, Perfusion methods, Postoperative Complications prevention & control, Retrospective Studies, Risk Factors, Treatment Outcome, Aorta, Thoracic diagnostic imaging, Aorta, Thoracic surgery, Cerebrovascular Circulation
Abstract

Aims: Selective antegrade cerebral perfusion technique is a method of cerebral protection used worldwide during aortic arch surgery. This study was designed to identify a potential correlation between perfusion flows and the development of postoperative transient neurological dysfunctions., Methods: From January 2015 to May 2020, 175 patients underwent elective surgical replacement of the aortic arch using selective antegrade cerebral perfusion at the Cardiac Surgery Unit of Sant'Orsola Hospital in Bologna. Considering that patients who developed a permanent neurological dysfunction and those who died before a possible evaluation of neurological status were excluded, the study population included 160 patients. The perfusion flows were collected and analyzed. Univariate and multivariate analyses were performed to identify the statistical risk factors involved in the onset of transient neurological dysfunctions., Results: The study population was divided into two groups: 138 patients (86.3%) without and 22 (13.8%) with postoperative transient neurological complications. Among the intra-operative parameters collected in the study, the univariate analysis showed that the indexed medium perfusion flow of selective antegrade cerebral perfusion was significantly lower in the transient neurological dysfunctions group (11.63 ± 2.41 ml/kg/min vs 12.62 ± 2.39 ml/kg/min, P -value = 0.03). The multivariate logistic regression analysis showed that the female gender ( P  = 0.004, OR = 4.816, IC = 1.636-14.174) was predictor of transient neurological dysfunctions., Conclusion: The results of the study showed that lower perfusion flows seem to be related to a higher probability of developing transient neurological dysfunctions. However, the analysis of a wider population is required to confirm these preliminary data., (Copyright © 2022 Italian Federation of Cardiology - I.F.C. All rights reserved.)

Published
2022
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12. Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey.

Author

Lezo A, Diamanti A, Marinier EM, Tabbers M, Guz-Mark A, Gandullia P, Spagnuolo MI, Protheroe S, Peretti N, Merras-Salmio L, Hulst JM, Kolaček S, Ee LC, Lawrence J, Hind J, D'Antiga L, Verlato G, Pukite I, Di Leo G, Vanuytsel T, Doitchinova-Simeonova MK, Ellegard L, Masconale L, Maíz-Jiménez M, Cooper SC, Brillanti G, Nardi E, Sasdelli AS, Lal S, and Pironi L

Subjects
Adult, Child, Chronic Disease, Cross-Sectional Studies, Female, Humans, Male, Intestinal Diseases epidemiology, Intestinal Diseases therapy, Intestinal Failure, Parenteral Nutrition, Home, Short Bowel Syndrome therapy
Abstract

Background: The European Society for Clinical Nutrition and Metabolism database for chronic intestinal failure (CIF) was analyzed to investigate factors associated with nutritional status and the intravenous supplementation (IVS) dependency in children. Methods: Data collected: demographics, CIF mechanism, home parenteral nutrition program, z-scores of weight-for-age (WFA), length or height-for-age (LFA/HFA), and body mass index-for-age (BMI-FA). IVS dependency was calculated as the ratio of daily total IVS energy over estimated resting energy expenditure (%IVSE/REE). Results: Five hundred and fifty-eight patients were included, 57.2% of whom were male. CIF mechanisms at age 1−4 and 14−18 years, respectively: SBS 63.3%, 37.9%; dysmotility or mucosal disease: 36.7%, 62.1%. One-third had WFA and/or LFA/HFA z-scores < −2. One-third had %IVSE/REE > 125%. Multivariate analysis showed that mechanism of CIF was associated with WFA and/or LFA/HFA z-scores (negatively with mucosal disease) and %IVSE/REE (higher for dysmotility and lower in SBS with colon in continuity), while z-scores were negatively associated with %IVSE/REE. Conclusions: The main mechanism of CIF at young age was short bowel syndrome (SBS), whereas most patients facing adulthood had intestinal dysmotility or mucosal disease. One-third were underweight or stunted and had high IVS dependency. Considering that IVS dependency was associated with both CIF mechanisms and nutritional status, IVS dependency is suggested as a potential marker for CIF severity in children.

Published
2022
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13. Endovascular treatment of penetrating atherosclerotic ulcers of the arch and thoracic aorta: In-hospital and 5-year outcomes.

Author

Murana G, Di Marco L, Fiorentino M, Buia F, Brillanti G, Lovato L, and Pacini D

Abstract

Objective: Thoracic endovascular aortic repair (TEVAR) is the treatment of choice for thoracic aorta diseases including penetrating aortic ulcer (PAU). The objective of this study was to analyze the results of TEVAR for the treatment of PAU in our population., Methods: From January 1999 to January 2019, 830 patients with type B aortic syndromes were treated with TEVAR in our institution. Of these we selected 73 patients treated for a PAU. Clinical and radiologic follow-up was performed in all patients., Results: Mean age of our population was 72 ± 8 years. Fifteen patients (20.5%) were treated in an emergency setting. The proximal landing zone was in arch zone 2 in 22 patients (30.1%). In-hospital mortality was 6.8% and was associated with acute presentation ( P  = .005). Distal arch delivery of the endograft was unrelated to mortality (Fisher exact test, P  = .157). Survival at 1 and 5 years was 81.7% and 67.3%, respectively. Sixteen patients underwent reintervention of the thoracic aorta. Patients who underwent emergency surgery and older patients had a shorter survival (log rank test, P  < .001). No difference in survival was shown according to the proximal landing zone (log rank P  = .292) or the dimension of the thoracic aorta (log rank P  = .067). In multivariable Cox regression analysis, only age older than 75 years was associated with 5-year mortality (hazard ratio, 6.60; 95% CI, 2.12-20.56); P  < .001)., Conclusions: The use of TEVAR for treatment of aortic PAU is a safe procedure in an elective setting despite necessity of arch stent grafting. An early intervention performed at smaller aortic diameters of <55 mm might be beneficial in selected patients to improve late survival., (© 2022 The Author(s).)

Published
2022
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14. Postoperative outcomes following rehabilitation in patients with left ventricular assist devices.

Author

Polastri M, Boschi S, Brillanti G, Martin-Suarez S, Masetti M, Potena L, and Loforte A

Subjects
Aged, Disability Evaluation, Female, Functional Status, Heart Failure physiopathology, Heart Failure psychology, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Postoperative Period, Quality of Life, Recovery of Function, Rehabilitation psychology, Walk Test statistics & numerical data, Heart Failure surgery, Heart-Assist Devices adverse effects, Postoperative Care rehabilitation, Rehabilitation methods
Abstract

Postoperative rehabilitation is a cornerstone of the recovery pathway following left ventricular assist device implantation (LVAD), and patients are expected to conduct an autonomous life thanks to improved technology and increased knowledge of mechanical circulatory support. The primary purpose of the present study was to quantify clinical changes related to rehabilitation, in patients with LVAD: functional capacity, disability, and quality of life were identified as reliable outcomes to detect such changes. The current study was a scoping review conducted searching three primary databases, namely PubMed, Scopus, and Cochrane Library, from their inception until January 2020. After the selection process was completed, 12 citations were included in the present study. Three hundred eight three patients were included in the current analysis. Functional capacity, disability, and quality of life were investigated in 157, 215, 18 patients, respectively. Significant differences were found before and after rehabilitation. The mean walked distance at 6-Minute Walk Test improved from 319±96 to 412.8±86.2 metres (p<0.001), the mean score of the Functional Independence Measure from 68.4±11.8 to 92.5±10.8 points (p<0.001), the mean score of the Short Form-36 physical component from 32.7±29.9 to 55.5±24.7 points (p=0.009) and the mental component from 55.8±19.8 to 75.4±21.4 points (p=0.002). Postoperative rehabilitation is effective at improving functional capacity, disability, and quality of life in patients with left ventricular assist device; all these three domains are particularly expressive of the entity of patients' functional recovery.

Published
2020
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