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. 2025 Nov 13;17(22):3551.
doi: 10.3390/nu17223551.

Health State Utility Associated with Parenteral Nutrition Requirement in Patients with Short Bowel Syndrome and Intestinal Failure in Korea: A Vignette-Based Approach

Hyewon Sim  1 , Jin Soo Moon  2 , Young Suk Park  3 , Eunji Heo  4 , Yoon Soo Chun  5 , Songhwa Choi  6 , Hyemin Ku  1 , Jae Hee Chung  7
Affiliations

Health State Utility Associated with Parenteral Nutrition Requirement in Patients with Short Bowel Syndrome and Intestinal Failure in Korea: A Vignette-Based Approach

Hyewon Sim et al. Nutrients. .

Abstract

Background/Objectives: Short bowel syndrome (SBS) is the leading cause of intestinal failure (IF) that often requires long-term parenteral nutrition (PN). Extended PN results in severe complications and reduced quality of life (QoL). This study aimed to evaluate the QoL utility weights associated with PN duration using vignettes. Methods: We developed detailed scenarios and descriptions to represent eight hypothetical health states, reflecting variations in PN frequency in both pediatric and adult patients. A cross-sectional survey was conducted among 359 Korean adults (aged 19-59 years) from the general population, assigned to evaluate adult (n = 179) or pediatric (n = 180) vignette groups. Health utility was measured using the EuroQol 5-Dimension (EQ-5D), visual analog scale (VAS), and time trade-off (TTO) methods. Multivariable regression analysis using a mixed-effects model was employed to manage repeated measures and control for sociodemographic variables. Results: Utility scores measured using the EQ-5D, VAS, and TTO were negatively correlated with increasing PN days in both adult and pediatric patients with SBS-IF. The highest mean utility values were "0 days on PN" (adults: EQ-5D 0.808, VAS 0.689, TTO 0.874; pediatric: EQ-5D 0.804, VAS 0.680, TTO 0.883), while the lowest were "7 days on PN" (adults: EQ-5D 0.117, VAS 0.180, TTO 0.272; pediatric: EQ-5D 0.070, VAS 0.178, TTO 0.291). These trends remained significant after covariate adjustment (p < 0.001). Conclusions: The study revealed a steady decline in utility values with an increasing number of PN days. These findings highlight the importance of enhancing the QoL in patients with SBS-IF by supporting intestinal adaptation and reducing PN dependency.

Keywords: health-related quality of life; intestinal failure; parenteral nutrition; short bowel syndrome; utility weights.

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Conflict of interest statement

The authors H. Sim, H. Ku, J.S. Moon, J.H. Chung, and Y.S. Park have no potential competing interests relevant to this article and have no conflicts of interest to declare. H. Sim is a full-time employee of NDnex, and H. Ku serves as the CEO of NDnex. Y.S. Chun and S. Choi are full-time employees of Takeda Pharmaceuticals Korea Co., Ltd., and E. Heo was a previous employee of Takeda Pharmaceuticals Korea Co., Ltd. This research was a Takeda-sponsored study. Takeda Pharmaceuticals Korea Co., Ltd. provided financial support across the stages of the research, including the study design, data collection, and medical writing/editorial support for manuscript preparation. Despite this support, the authors had full access to all data, conducted the analyses independently, and are responsible for the content of the manuscript and the decision to submit.

Figures

Figure 1
Figure 1
Flow chart of survey participation.
Figure 2
Figure 2
Mean utility values derived from EQ-5D-5L, VAS and TTO. (a) Adult vignettes, (b) Pediatric vignettes. EQ-5D-5L: 5-level EQ-5D; VAS: visual analogue scale; TTO: time trade-off.
See this image and copyright information in PMC

References

    1. Billiauws L., Maggiori L., Joly F., Panis Y. Medical and surgical management of short bowel syndrome. J. Visc. Surg. 2018;155:283–291. doi: 10.1016/j.jviscsurg.2017.12.012. - DOI - PubMed
    1. Amiot A., Messing B., Corcos O., Panis Y., Joly F. Determinants of home parenteral nutrition dependence and survival of 268 patients with non-malignant short bowel syndrome. Clin. Nutr. 2013;32:368–374. doi: 10.1016/j.clnu.2012.08.007. - DOI - PubMed
    1. Sigalet D.L. Short bowel syndrome in infants and children: An overview. Semin. Pediatr. Surg. 2001;10:49–55. doi: 10.1053/spsu.2001.22382. - DOI - PubMed
    1. Massironi S., Cavalcoli F., Rausa E., Invernizzi P., Braga M., Vecchi M. Understanding short bowel syndrome: Current status and future perspectives. Dig. Liver Dis. 2020;52:253–261. doi: 10.1016/j.dld.2019.11.013. - DOI - PubMed
    1. Lee T., Cho Y., Park K. Prevalence and disease burden of patients with short bowel syndrome in Korea. Health Insur. Rev. Assess. Serv. 2018;2:34–37.

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