Elisabeth Blüthner1,2, Jan Bednarsch3, Martin Stockmann1,4, Mirjam Karber2,5, Sophie Pevny2, Sebastian Maasberg2,6, Undine A Gerlach1, Andreas Pascher1,7, Bertram Wiedenmann2, Johann Pratschke1, Ulrich-Frank Pape2,6. 1. Department of Surgery, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany. 2. Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany. 3. Department of General, Visceral, and Transplantation Surgery, University Hospital Aachen, Rhine-Westphalia Institute of Technology, Aachen, Germany. 4. Department of General, Visceral, and Vascular Surgery, Evangelisches Krankenhaus Paul Gerhardt Stift, Lutherstadt Wittenberg, Germany. 5. Berlin Institute of Health, Berlin, Germany. 6. Department of Internal Medicine and Gastroenterology, Asklepios Klinik St. Georg, Asklepios Medical School, Hamburg, Germany. 7. Department of General, Visceral, and Transplantation Surgery, Münster University Hospital, Münster, Germany.
Abstract
BACKGROUND: Parenteral nutrition (PN) is a life-sustaining therapy for patients with chronic intestinal failure (IF) but inevitably has an impact on patients' quality of life (QoL). The purpose of this study was to examine multiple aspects of QoL by utilizing the standardized Short Form 36 (SF-36) health survey. METHODS: Between 2014 and 2017, a total of 90 adult patients with IF who were receiving PN were prospectively enrolled in an observational study. All subjects underwent nutrition status assessment, liver assessment, blood tests, and QoL assessment based on the SF-36. Univariate and multivariable analyses were performed to identify determinants of 8 domains and 2 summary scales of the SF-36. RESULTS: Analysis of the SF-36 questionnaire data showed that QoL was significantly worse compared with the general German population across all categories. Multivariable analysis revealed that bioelectrical impedance analysis of phase angle (1/10 categories), stoma/fistula (4/10 categories), oral intake (4/10 categories), infusions per week (1/10 categories), duration of PN (1/10 categories), citrulline (4/10 categories), and hemoglobin levels (1/10 categories) are independent risk factors affecting QoL. CONCLUSION: This study uses the largest cohort of IF patients assessed by the standardized SF-36 questionnaire to comprehensively analyze QoL. Presence of oral intake, presence of ostomy, and citrulline levels were independently correlated with 4 of 10 categories of the SF-36. These results indicate that to improve QoL for IF patients, clinical care should focus on addressing the social and emotional value of oral intake, educational interventions, early stoma closure, and application of new targeted therapies.
BACKGROUND: Parenteral nutrition (PN) is a life-sustaining therapy for patients with chronic intestinal failure (IF) but inevitably has an impact on patients' quality of life (QoL). The purpose of this study was to examine multiple aspects of QoL by utilizing the standardized Short Form 36 (SF-36) health survey. METHODS: Between 2014 and 2017, a total of 90 adult patients with IF who were receiving PN were prospectively enrolled in an observational study. All subjects underwent nutrition status assessment, liver assessment, blood tests, and QoL assessment based on the SF-36. Univariate and multivariable analyses were performed to identify determinants of 8 domains and 2 summary scales of the SF-36. RESULTS: Analysis of the SF-36 questionnaire data showed that QoL was significantly worse compared with the general German population across all categories. Multivariable analysis revealed that bioelectrical impedance analysis of phase angle (1/10 categories), stoma/fistula (4/10 categories), oral intake (4/10 categories), infusions per week (1/10 categories), duration of PN (1/10 categories), citrulline (4/10 categories), and hemoglobin levels (1/10 categories) are independent risk factors affecting QoL. CONCLUSION: This study uses the largest cohort of IFpatients assessed by the standardized SF-36 questionnaire to comprehensively analyze QoL. Presence of oral intake, presence of ostomy, and citrulline levels were independently correlated with 4 of 10 categories of the SF-36. These results indicate that to improve QoL for IFpatients, clinical care should focus on addressing the social and emotional value of oral intake, educational interventions, early stoma closure, and application of new targeted therapies.
Authors: Ulrich-Frank Pape; Kishore R Iyer; Palle B Jeppesen; Marek Kunecki; Loris Pironi; Stéphane M Schneider; Douglas L Seidner; Hak-Myung Lee; John Caminis Journal: Therap Adv Gastroenterol Date: 2020-04-20 Impact factor: 4.409
Authors: Elisabeth Blüthner; Ulrich-Frank Pape; Martin Stockmann; Mirjam Karber; Sebastian Maasberg; Sophie Pevny; Undine Gerlach-Runge; Andreas Pascher; Johann Pratschke; Frank Tacke; Jan Bednarsch Journal: Nutrients Date: 2020-04-26 Impact factor: 5.717
Authors: Samuel A Kocoshis; Russell J Merritt; Susan Hill; Susan Protheroe; Beth A Carter; Simon Horslen; Simin Hu; Stuart S Kaufman; David F Mercer; Mikko P Pakarinen; Robert S Venick; Paul W Wales; Andrew A Grimm Journal: JPEN J Parenter Enteral Nutr Date: 2019-09-08 Impact factor: 4.016