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

Loris Pironi (1, 2) , Ezra Steiger (3) , Francisca Joly (4) , Palle Jeppesen (5) , Geert Wanten (6) , Anna Sasdelli (1) , Cecile Chambrier (7) , Umberto Aimasso (8) , Manpreet Mundi (9) , Kinga Szczepanek (10) , Amelia Jukes (11) , Miriam Theilla (12) , Marek Kunecki (13) , Joanne Daniels (14) , Mireille Serlie (15) , Florian Poullenot (16) , Sheldon Cooper (17) , Henrik Rasmussen (18) , Charlene Compher (19) , David Seguy (20) , Adriana Crivelli (21) , Lidia Santarpia (22) , Francesco Guglielmi (23) , Nada Rotovnik Kozjek (24) , Stéphane Schneider (25) , Lars Ellegard (26) , Ronan Thibault (2) , Przemysław Matras , Konrad Matysiak , Andrè van Gossum , Alastair Forbes , Nicola Wyer , Marina Taus , Nuria Virgili , Margie O'Callaghan , Brooke Chapman , Emma Osland , Cristina Cuerda , Gábor Udvarhelyi , Lynn Jones , Andre Won Lee , Luisa Masconale , Paolo Orlandoni , Corrado Spaggiari , Marta Bueno Díez , Maryana Doitchinova-Simeonova , Aurora 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 Suárez-Llanos , Nader Youssef , Giorgia Brillanti , Elena Nardi , Simon Lal , Hector Solar Muñiz , Ruth Hodgson , Siobhan Wallin , Kay Lasenby , 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 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 , Denise Jezerski (3)

1 University of Bologna/Università di Bologna
2 NuMeCan - Nutrition, Métabolismes et Cancer
3 Cleveland Clinic
4 Service de Gastroentérologie [Hôpital Beaujon]
5 Rigshospitalet [Copenhagen]
6 Radboud University Medical Center [Nijmegen]
7 HCL - Hospices Civils de Lyon
8 Città della Salute e della Scienza University-Hospital
9 Mayo Clinic and Mayo College of Medicine
10 Stanley Dudrick's Memorial Hospital
11 UHW - University Hospital of Wales
12 TAU - Tel Aviv University
13 University of Lódź
14 Nottingham University Hospitals NHS Trust [UK]
15 VU University Medical Center [Amsterdam]
16 CHU Bordeaux [Bordeaux]
17 University Hospitals Birmingham NHS Foundation Trust
18 Aalborg University Hospital
19 HUP - Hospital of the University of Pennsylvania
20 CHRU Lille - Centre Hospitalier Régional Universitaire [Lille]
21 Hospital Universitario Fundacion Favaloro
22 University of Naples Federico II = Università degli studi di Napoli Federico II
23 Monsignor di Miccoli Hospital
24 Institute of Oncology - Ljubljana
25 CHU Nice - Centre Hospitalier Universitaire de Nice
26 GU - University of Gothenburg

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.

Keywords: Epidemiology; Home parenteral nutrition; Intestinal failure; Intravenous supplementation; Short bowel syndrome

Domains: Life Sciences [q-bio]

Loris Pironi, Ezra Steiger, Francisca Joly, Palle Jeppesen, Geert Wanten, et al.. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey. Clinical Nutrition ESPEN, 2021, 45, pp.433-441. ⟨10.1016/j.clnesp.2021.07.004⟩. ⟨hal-03418977⟩