Home parenteral nutrition in Denmark in the period from 1996 to 2001

Abstract

Objective: Home parenteral nutrition (HPN) has been provided to patients with intestinal failure in Denmark since 1970. The results of a national survey comprising a well-defined cohort receiving treatment with HPN in Denmark in the period from 1996 to the end of 2000 are presented, including data on incidence, prevalence, patient characteristics and complications of HPN treatment.

Material and methods: HPN was given to 202 patients (115 F, 87 M) 34% with short-bowel syndrome due to inflammatory bowel disease, 26% with cancer, 22% with surgical complications and 19% with other causes, for a total of 410 catheter years.

Results: At the end of 2000, the prevalence of HPN in Denmark was 19.2 per million, and the average annual incidence was 5.0 per million per year over the 5-year period. The incidence rates of catheter-related bacteraemia and thrombosis were 0.48 and 0.02 episodes per catheter year, respectively. The average catheter lasted 1.5 years. Venous inaccessibility was never encountered. The 5-year mortality was 25% (n = 51). However, only six deaths were related to HPN. Three patients died of HPN-related liver failure, two died of catheter-related sepsis and one patient died of an embolus induced by a catheter thrombus.

Conclusions: Since its introduction in 1970 in Denmark, HPN has evolved from an experimental approach to a standardized therapy for patients with intestinal failure. Although HPN morbidity is increasing slightly compared with that reported in earlier surveys, HPN-induced mortality is still less than 1% per year.