TY - JOUR
T1 - Longitudinal evolution of catheter-related bloodstream infections, kidney function and liver status in a nationwide adult intestinal failure cohort
AU - Pohju, Anne K.
AU - Hakkarainen, Antti I.
AU - Pakarinen, Mikko P.
AU - Sipponen, Taina M.
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022/7/3
Y1 - 2022/7/3
N2 - Objectives: The development of intestinal failure-related complications in Finnish adults is unknown. This study aimed to investigate the incidence of catheter-related bloodstream infections (CRBSI), and the longitudinal changes in biochemical liver and kidney tests in a nationwide cohort. Materials and methods: The search for Finnish adults with intestinal failure (IF) utilized a survey to Finnish health-care providers (n = 111) with the potential to provide long-term parenteral support (PS) for adult IF. Our nationwide, cross-sectional cohort included all IF patients aged ≥ 18 years who had received PS for ≥ 120 d in 2017. Data regarding CRBSI and biochemical liver and kidney tests were collected from patient records at the start of PS up to the latest available measurement in 2017. Results: In the nationwide cohort of 52 patients, the CRBSI incidence was 1.35/1000 catheter days. Seventy-three percent of CRBSI in a long-term catheter led to catheter replacement. During a median PS duration of 27.5 (interquartile range [IQR] 11.3–57.3) months, a statistically significant median change occurred in estimated glomerular filtration rate (eGFR; −8.5 ml/min/1.73 m2, IQR −30–7, p =.005) and alkaline phosphatase (ALP; 26 U/l, IQR −11–95, p =.019). In a multiple regression model for eGFR at data collection, baseline eGFR and age were strong explanatory variables. Conclusions: Incidence of CRBSI, but not treatment strategies, in this nationwide adult IF population correspond well to those reported from specialized centers. Decreased kidney function and abnormal liver test results are frequent findings, and even more so over time, emphasizing the importance of regular monitoring.
AB - Objectives: The development of intestinal failure-related complications in Finnish adults is unknown. This study aimed to investigate the incidence of catheter-related bloodstream infections (CRBSI), and the longitudinal changes in biochemical liver and kidney tests in a nationwide cohort. Materials and methods: The search for Finnish adults with intestinal failure (IF) utilized a survey to Finnish health-care providers (n = 111) with the potential to provide long-term parenteral support (PS) for adult IF. Our nationwide, cross-sectional cohort included all IF patients aged ≥ 18 years who had received PS for ≥ 120 d in 2017. Data regarding CRBSI and biochemical liver and kidney tests were collected from patient records at the start of PS up to the latest available measurement in 2017. Results: In the nationwide cohort of 52 patients, the CRBSI incidence was 1.35/1000 catheter days. Seventy-three percent of CRBSI in a long-term catheter led to catheter replacement. During a median PS duration of 27.5 (interquartile range [IQR] 11.3–57.3) months, a statistically significant median change occurred in estimated glomerular filtration rate (eGFR; −8.5 ml/min/1.73 m2, IQR −30–7, p =.005) and alkaline phosphatase (ALP; 26 U/l, IQR −11–95, p =.019). In a multiple regression model for eGFR at data collection, baseline eGFR and age were strong explanatory variables. Conclusions: Incidence of CRBSI, but not treatment strategies, in this nationwide adult IF population correspond well to those reported from specialized centers. Decreased kidney function and abnormal liver test results are frequent findings, and even more so over time, emphasizing the importance of regular monitoring.
KW - CRBSI
KW - home parenteral nutrition
KW - IFALD
KW - renal failure
KW - Short bowel syndrome
UR - http://www.scopus.com/inward/record.url?scp=85125293741&partnerID=8YFLogxK
U2 - 10.1080/00365521.2022.2039281
DO - 10.1080/00365521.2022.2039281
M3 - Article
C2 - 35174757
AN - SCOPUS:85125293741
SN - 0036-5521
VL - 57
SP - 763
EP - 767
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
IS - 7
ER -