Enriquez-Sánchez LB, Carrillo-Gorena MJ, Granados-Aldaz LA, Balderrama-Miramontes LF, Gallegos-Portillo LG, Reza-Leal CN, González-Villa A, Fernández-Villalobos K

Language: English
References: 24
Page: 559-563
PDF size: 149.67 Kb.

ABSTRACT

Background: Intestinal failure (IF) was first defined as “a reduction in the functioning gut mass below the minimal amount necessary for adequate digestion and absorption.” In our environment, there are no statistical data for IF in adult patients’ extended length of stay (LOS), nor the economic impact that it implies. Objective: The objective of the study was to describe the association between the IF type and extended LOS. Methods: Patients admitted to our IF Unit between March 2016 and March 2018 were enrolled. We conducted a 2-year retrospective cross-sectional study. Results: From the total of 53 patients, 35% corresponded to type I IF, 58.5% to type II IF, and 7.5% to type III IF. The mean LOS, according to the type of functional IF was 51 days for type I, 77.48 days for type II, and 68.25 days for type III. The mean LOS for the three IF types was 67.79 days. Conclusion: Extended LOS occurs in an important proportion of patients with IF, resulting in increased morbidity and mortality, as well as in costs and associated side effects. Future research should focus on economic studies, to know the economic impact that this subject entails for our health systems.

REFERENCES

1. Fleming CR, Remington M. Intestinal failure. In: Hill GI, editor. Nutrition and the Surgical Patient Clinical Surgery International. Vol. 2. Edinburgh: Churchill Livingstone; 1981. p. 219-35.

2. Shaffer J. Intestinal failure: definition and service development. Am J Clin Nutr. 2002;21 Suppl 1:144e5.

3. Kappus M, Diamond S, Hurt RT, Martindale R. Intestinal failure: new definition and clinical implications. Curr Gastroenterol Rep. 2016;18:48.

4. Bo M, Fonte G, Pivaro F, Bonetto M, Comi C, Giorgis V, et al. Prevalence of and factors associated with prolonged length of stay in older hospitalized medical patients. Geriatr Gerontol Int. 2016;16:314-21.

5. Barba R, Marco J, Canora J, Plaza S, Juncos SN, Hinojosa J, et al. Prolonged length of stay in hospitalized internal medicine patients. Eur J Intern Med. 2015;26:772-5.

6. Neelis EG, Roskott AM, Dijkstra G, Wanten GJ, Serlie MJ, Tabbers MM, et al. Presentation of a nationwide multicenter registry of intestinal failure and intestinal transplantation. Clin Nutr. 2016;35:225-9.

7. Geoghegan AR, Donohoe CL, Reynolds JV. Acute intestinal failure in surgical patients: an audit of incidence, management and outcomes in an Irish hospital, and compliance with ASGBI guidelines. Ir J Med Sci. 2012; 181:467-71.

8. Donaldson E, Taylor M, Abraham A, Carlson G, Fletcher O, Varden J, et al. Improving quality in a national intestinal failure unit: greater efficiency, improved access and reduced mortality. Frontline Gastroenterol. 2015;6:182-93.

9. Davidson J, Plumb A, Burnett H. Adult intestinal failure. Clin Radiol. 2010;65:395-402.

10. Rudolph JA, Squires R. Current concepts in the medical management of pediatric intestinal failure. Curr Opin Organ Transplant. 2010;15:324-9.

11. Pironi L, Arends J, Baxter J, Bozzetti F, Peláez RB, Cuerda C, et al. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults. Clin Nutr. 2015;34:171-80.

12. Klek S, Forbes A, Gabe S, Holst M, Wanten G, Irtun Ø, et al. Management of acute intestinal failure: a position paper from the European society for clinical nutrition and metabolism (ESPEN) special interest group. Clin Nutr. 2016;35:1209-18.

13. Pironi L, Arends J, Bozzetti F, Cuerda C, Gillanders L, Jeppesen PB, et al. ESPEN guidelines on chronic intestinal failure in adults. Clin Nutr. 2016;35:247-307.

14. ESCP Intestinal Failure Group:, Vaizey CJ, Maeda Y, Barbosa E, Bozzetti F, Calvo J, et al. European society of coloproctology consensus on the surgical management of intestinal failure in adults. Colorectal Dis. 2016;18:535-48.

15. Roskott AM, Groen H, Rings EH, Haveman JW, Ploeg RJ, Serlie MJ, et al. Cost-effectiveness of intestinal transplantation for adult patients with intestinal failure: a simulation study. Am J Clin Nutr. 2015; 101:79-86.

16. Bateni SB, Meyers FJ, Bold RJ, Canter RJ. Increased rates of prolonged length of stay, readmissions, and discharge to care facilities among postoperative patients with disseminated malignancy: implications for clinical practice. PLoS One. 2016;11:e0165315.

17. González-Angulo IJ, Rivas-González GC, Romero-Cedano A, Cortina- Gómez B. Relación entre el prestador de servicio de salud y la estancia prolongada en el hospital. Rev. Conamed. 2009;14:21-4.

18. Ceballos-Acevedo T, Velásquez-Restrepo PA, Jaén-Posada JS. Duración de la estancia hospitalaria. Metodologías para su intervención. Rev Gerenc Polít Salud. 2014;13:274-95.

19. Iyer S, Saunders WB, Stemkowski S. Economic burden of postoperative ileus associated with colectomy in the United States. J Manag Care Pharm. 2009;15:485-94.

20. Ricciardi R, Roberts PL, Read TE, Hall JF, Marcello PW, Schoetz DJ, et al. Which adverse events are associated with mortality and prolonged length of stay following colorectal surgery? J Gastrointest Surg. 2013;17:1485-93.

21. Karagozian R, Johannes RS, Sun X, Burakoff R. Increased mortality and length of stay among patients with inflammatory bowel disease and hospital-acquired infections. Clin Gastroenterol Hepatol. 2010;8:961-5.

22. Tevis SE, Carchman EH, Foley EF, Harms BA, Heise CP, Kennedy GD, et al. Postoperative ileus more than just prolonged length of stay? J Gastrointest Surg. 2015;19:1684-90.

23. Asgeirsson T, El-Badawi KI, Mahmood A, Barletta J, Luchtefeld M, Senagore AJ, et al. Postoperative ileus: it costs more than you expect. J Am Coll Surg. 2010;210:228-31.

24. Bada-Yllán O, Téllez-Avila FI, Takahashi-Monroy T, Hoyos-Tello CM, Zárate X, García-Osogobio S, et al. Surgical and medical treatment outcome of enterocutaneus fistulas. Acta Gastroenterol Latinoam. 2009;39:273-7.