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Observational Study
. 2025 Jun;121(6):1387-1394.
doi: 10.1016/j.ajcnut.2025.02.032. Epub 2025 Mar 10.

Survival and parenteral nutrition dependence in patients aged 65 y and older with short bowel syndrome: a retrospective observational cohort study

Mélanie Draullette  1 , Brune de Dreuille  2 , Manuel Sanchez  3 , Julie Bataille  4 , Lore Billiauws  4 , Alexandre Nuzzo  4 , Francisca Joly  5
Affiliations
Observational Study

Survival and parenteral nutrition dependence in patients aged 65 y and older with short bowel syndrome: a retrospective observational cohort study

Mélanie Draullette et al. Am J Clin Nutr. 2025 Jun.

Abstract

Background: Home parenteral support (PS) is the standard treatment of chronic intestinal failure (CIF) with short bowel syndrome (SBS) as the leading cause. However, outcomes of PS in older patients remain poorly studied.

Methods: This retrospective observational study evaluated patients with newly diagnosed SBS-CIF initiating PS between 2015 and 2020 at a national French CIF referral center. Patients were stratified into 2 groups: 65 y or older (older group) and younger than 65 y (younger group). Multivariate Cox regression identified predictors of mortality and PS dependence in older patients.

Results: We included 175 patients [median age: 61 y (IQR: 46-70 y); 58% female]. Mesenteric ischemia was the primary cause of CIF (32%). Surgical anatomy included jejunostomy (47%), jejunocolic (39%), and ileocolic anastomosis (14%). Older patients [n = 73 (42%); median age: 72 y; IQR: 68-76 y] had higher rates of arterial hypertension, dyslipidemia, cancer, and SBS-CIF caused by radiation enteritis, but fewer cases attributed to Crohn disease. After a median follow-up of 27 mo (95% confidence interval [CI]: 22, 32 mo), the probability of survival was 92% (95% CI: 88%, 97%), and the probability of PS dependence was 68% (95% CI: 60%, 785), with no significant difference between age groups. In older patients, the presence of a jejunostomy (hazard ratios [HR]: 3.4; 95% CI: 1.1, 10.6) was an independent predictor of PS dependence, and BMI of <22 kg/m2 (HR: 10.9; 95% CI: 1.4, 87.4) was an independent predictor of mortality. Fourteen patients (8%) were treated with teduglutide, with no significant difference between age groups.

Conclusions: Nearly half of patients with SBS-CIF on PS are aged 65 y or older, with PS dependence and survival rates comparable with those of younger patients. These findings suggest that age should not be a barrier to PS initiation.

Keywords: elderly; intestinal failure; older patients; parenteral nutrition; parenteral support; short bowel syndrome.

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Conflict of interest statement

Conflict of interest FJ is a consultant or advisor to Takeda VectivBio, Ironwood, NorthSea Therapeutics, Hamni, Zealand, Mobile3esolutions, and Carembouch; receives research funding from Takeda Pharma, VectivBio, Zealand, and Baxter; is a lecturer for dor Baxter, BBraun, Fresenius Kabi, Janssen, and Theradia. AN has received speaker or consultancy fees from Abbvie, Amgen, and Janssen; research funding from MSD-Avenir; and PhD grants from Fondation de l’Avenir and SNFGE. BdD received a research grant from Takeda. The other authors report no conflicts of interest.

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