Abstract | OBJECTIVES: METHODS: This study included patients with CD receiving HPN for intestinal failure. The patients were treated at Osaka University Hospital between January 2000 and December 2019. Patients' demographic characteristics, HPN dependence and complications, and mortality were analyzed. HPN dependence was estimated using the Kaplan-Meier method. Cox regression analysis was used for between-group comparisons. RESULTS: Twenty-one patients with CD received HPN. HPN dependence rates were 85%, 75%, 75%, and 64%, respectively, at 2, 5, 10, and 15 y after HPN initiation. Patients who weaned off HPN exhibited lower rates of immunomodulator therapy and additional intensive CD treatment (P < 0.05). Multivariate analysis revealed that not requiring additional intensive CD treatment was a significant factor in weaning off HPN. Two patients (9%) died, at a median of 14.9 y after HPN initiation, due to HPN-related liver disease and CD-associated carcinoma. Among all patients, 61% experienced catheter-related bloodstream infections (CRBSIs), with an incidence of 0.32/1000 catheter-days. Methicillin-resistant bacteria and Candida spp. each accounted for 27% of all pathogens detected in CRBSI. CONCLUSIONS: Patients with CD receiving HPN had a good prognosis, despite frequent CRBSIs in which methicillin-resistant bacteria and fungi were common pathogens. Some patients with CD can wean off HPN, even after a long period of HPN treatment. A stable disease condition during HPN might be an important factor for weaning off HPN.
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Authors | Yoshifumi Watanabe, Tsunekazu Mizushima, Shiki Fujino, Takayuki Ogino, Norikatsu Miyoshi, Hidekazu Takahashi, Mamoru Uemura, Chu Matsuda, Hirofumi Yamamoto, Yuichiro Doki, Hidetoshi Eguchi |
Journal | Nutrition (Burbank, Los Angeles County, Calif.)
(Nutrition)
Vol. 78
Pg. 110903
(10 2020)
ISSN: 1873-1244 [Electronic] United States |
PMID | 32736298
(Publication Type: Journal Article)
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Copyright | Copyright © 2020 Elsevier Inc. All rights reserved. |
Topics |
- Crohn Disease
(therapy)
- Humans
- Incidence
- Liver Diseases
- Parenteral Nutrition, Home
- Retrospective Studies
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