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From hospital unit to intestinal failure center: Twenty years of history
- Source :
- Clinical Nutrition. 40:3787-3792
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Summary Aim Home parenteral nutrition (HPN) is one of the most demanding medical therapies as it is the only option for patients for intestinal failure (IF). No unequivocal policy on how to start and progress with HPN has ever been presented. The IF Center at the Stanley Dudrick's Memorial Hospital in Skawina is one of the biggest centers in Poland, celebrating its twentieth birthday last year. It offered the unique chance to present how to create and grow the IF center, increasing the quality of care. The above became the aim of this study. Methods A retrospective analysis of all medical records of HPN patients from the University Hospital and Stanley Dudrick's Memorial Hospital in Skawina. Patient profile, clinical course and treatment outcomes were assessed. The evolution of all aspects of HPN is presented. A brief historical perspective has been added to better illustrate the center's growth and transformation. Results 608 patients (363 female, 245 male, mean age 55.55 year) from all over Poland were treated between December 1999 and December 2019. The most frequent indication for HPN was mechanical obstruction (277, 45.7%), followed by short bowel syndrome (SBS, 208, 34.3%) and intestinal fistula (46, 7.59%). The most common primary disease was cancer (n = 267), followed by mesenteric ischemia (n = 104), and surgical complications (n = 62). 314 patients (51.8%) died. 73 (12.04%) were successfully weaned off PN. The catheter infection rate reached 0.39/1000 catheter days. Conclusions the founding of the HPN center and its further development is possible provided that there is team of dedicated people, supported by hospital base. The real growth opportunity is guaranteed by the reimbursement. It is necessary to adapt to the changing circumstances.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Patients
Fistula
030209 endocrinology & metabolism
Critical Care and Intensive Care Medicine
History, 21st Century
Hospitals, Special
Intestinal Failure
03 medical and health sciences
0302 clinical medicine
Intestinal failure
medicine
Humans
Reimbursement
Retrospective Studies
030109 nutrition & dietetics
Nutrition and Dietetics
business.industry
Medical record
General surgery
History, 20th Century
medicine.disease
Short bowel syndrome
Catheter
Parenteral nutrition
Mesenteric ischemia
Poland
Parenteral Nutrition, Home
business
Delivery of Health Care
Subjects
Details
- ISSN :
- 02615614
- Volume :
- 40
- Database :
- OpenAIRE
- Journal :
- Clinical Nutrition
- Accession number :
- edsair.doi.dedup.....b9f271650fc9fd9e06b526cbde302c77