Research

Management of intestinal failure in Europe. A questionnaire based study on the incidence and management

Michael Staun¹ , Xavier Hebuterne² , Jon Shaffer³ , Kent V Haderslev¹ , Frederico Bozzetti⁴ , Marek Pertkiewicz⁵ , Ann Micklewright⁶ , Jose Moreno⁷ , Paul Thul⁸ and Loris Pironi⁹

¹Department of Medical Gastroenterology, Rigshospitalet, Copenhagen, Denmark

²Department of Gastroenterology and Clinical Nutrition, Archet University Hospital, Nice, France

³Intestinal Failure Unit Hope Hospital, Salford, UK

⁴Department of Surgery, Hospital of Prato, Prato, Italy

⁵Department of Nutrition and Surgery, W. Orlowski University Hospital, Warsaw, Poland

⁶University Hospital, Queen's Medical Centre, Nottingham, UK

⁷Department of Nutricion Clinica Y Dietetica, Hospital 12de Octobre, Madrid, Spain

⁸Department of Surgery, Charité University Hospital, Berlin, Germany

⁹Department of Internal Medicine and Gastroenterology, Center for Chronic Intestinal Failure, St. Orsola-Malpighi Hospital, Bologna, Italy

author email corresponding author email

Dynamic Medicine 2007, 6:7doi:10.1186/1476-5918-6-7

Published:	4 July 2007

Abstract

Background

Intestinal failure is the outcome of a number of gastrointestinal diseases and characterized by significant reduction in functional gut mass. If not resolved patients often face long-term nutritional support. This study gathered information about how patients referred with intestinal failure are managed in specialised European centres.

Methods

A questionnaire was circulated in 7 European countries via representatives of the ESPEN-HAN working group to seek information about experience in treating patients with intestinal failure. We asked about clinical outcome, information about structure and organisation of the department, referral criteria, treatment procedures and guidelines.

Results

17 centres in 6 European countries completed the questionnaire: UK, n = 6, France, n = 4, Spain, n = 3, Denmark, n = 2, Italy, n = 1, Poland, n = 1. The experience of the centres in treating patients was in the range 12–30 years. The total number of patients on HPN in all centres was 590. The number of patients referred to centres with intestinal failure during the period January to December 2000 was n = 882: UK, n = 375 (range 2–175), France, n = 308 (range 24–182), Italy and Spain, n = 43 (range 9–52), Denmark n = 51 (range 14–37), the centre in Poland included 53 patients. Comparing all centres the following distribution among patients (median % (range%)) with regard to the endpoints were reported: Oral nutrition 32% (23–50%), enteral/tube feeding 11% (4–23%), HPN 36% (15–57%), lost to follow up 10% (0–35%), dead 9% (5–18%). No patients had an intestinal transplant.

Conclusion

The study provides information about how patients with intestinal failure are managed across Europe and the data indicates that treatment practice varies between countries.