1. Catheter-related complications in long-term home parenteral nutrition patients with chronic intestinal failure
- Author
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A. Guglielmi, Silvia Mazzuoli, N. Regano, S. Fregnan, G. Leogrande, Francesco William Guglielmi, M. Rizzi, and I. Addante
- Subjects
Adult ,Male ,Short Bowel Syndrome ,medicine.medical_specialty ,Catheterization, Central Venous ,Time Factors ,Population ,Gastroenterology ,Patient Readmission ,Sepsis ,Catheters, Indwelling ,Quality of life ,Risk Factors ,Internal medicine ,Neoplasms ,medicine ,Central Venous Catheters ,Humans ,education ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Incidence ,Cancer ,Middle Aged ,medicine.disease ,Short bowel syndrome ,Chronic intestinal failure ,Anorexia ,Parenteral nutrition ,Treatment Outcome ,Italy ,Nephrology ,Catheter-Related Infections ,Chronic Disease ,Surgery ,Female ,business ,Parenteral Nutrition, Home - Abstract
Background Home Parenteral Nutrition is a therapeutic option to improve quality of life in chronic intestinal failure. Aims To describe frequency of complications both in cancer and non-cancer 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 non-cancer. 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 non-cancer (0.91) patients while a statistically significant difference was observed between cancer (0.71) and non-cancer (0.46) patients for sepsis. Bacterial infections were more frequent in non-cancer, 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.
- Published
- 2012