AI Article Synopsis
- The International Intestinal Failure Registry (IIFR) studied outcomes of intestinal failure in a large pediatric group, focusing on identifying factors that affect achieving enteral autonomy within the first year.
- The study involved 189 patients, primarily with short bowel syndrome, and found that 51.6% achieved early enteral autonomy, while 6.5% died; key findings showed that having an ostomy increased the time needed for enteral autonomy.
- The results suggest that reducing bowel resection and performing ostomy reversal can help children with intestinal failure achieve enteral autonomy more quickly.
Article Abstract
Introduction: The International Intestinal Failure Registry (IIFR) is an international consortium to study intestinal failure (IF) outcomes in a large contemporary pediatric cohort. We aimed to identify predictors of early (1-year) enteral autonomy.
Methods: We included IIFR pilot phase patients. IF was defined by a parenteral nutrition need for at least 60 days due to a primary gastrointestinal etiology. The primary outcome was time to enteral autonomy achievement. We built a mixed-effects Weibull accelerated failure time model with random effects by center to analyze variables associated with enteral autonomy achievement with a primary outcome of time ratio (TR).
Results: We included 189 patients (82% with short bowel syndrome) representing 11 international centers. Cumulative incidence of early enteral autonomy was 51.6%, and death was 6.5%. In multivariable analysis, ostomy presence (TR, 2.63; 95% CI, 1.41-4.90) was associated with increased time to enteral autonomy achievement, and Asian/Indian (TR, 0.28; 95% CI, 0.10-0.81) and Pacific Islander race (TR, 0.34; 95% CI, 0.13-0.90) were associated with decreased time to enteral autonomy achievement. In a second model in the subset with measured percentage of bowel length remaining, ostomy presence (TR, 4.21; 95% CI, 1.90-9.33) was associated with increased time to enteral autonomy achievement, whereas greater percentage of bowel remaining (TR, 0.96; 95% CI, 0.94-0.98) was associated with decreased time to enteral autonomy achievement.
Conclusions: Minimizing bowel resection at initial surgery and establishing bowel continuity by ostomy reversal can effectively decrease the time to early enteral autonomy achievement in children with IF.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10843595 | PMC |
| http://dx.doi.org/10.1002/jpen.2557 | DOI Listing |
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