Incidence of chronic intestinal failure due short bowel syndrome in adults: A feasibility study

Abstract

Background: The incidence of short bowel syndrome associated chronic intestinal failure (SBS-CIF) is entirely unknown. A feasibility study was carried out in the tertiary-level hospital of the Bologna University (Italy), to test a protocol devised to investigate the in-hospital and the population incidences of SBS-CIF.

Methods: A 3-month (January-March 2024) retrospective survey was carried out in the two digestive disease surgical units of the hospital. Patient inclusion criteria were: age ≥18 years, abdominal surgery with small bowel resection and no-home parenteral nutrition (HPN) before hospital admission. Exclusion criterion: patient already on HPN at hospital admission. Criterion for the diagnosis of "SBS-CIF" was patient discharge on HPN within 3 months from inclusion of the study (end of the follow-up, June 30th 2024). The 3-month in-hospital and population incidences were calculated as percentage of patients who underwent abdominal surgery with a small bowel resection procedure and who developed SBS-CIF, and as "SBS-CIF" per million of inhabitants of the Bologna metropolitan area, respectivelyy.

Results: Sixty-seven patients met the inclusion criteria. At June 30th, 56 patients were discharged without HPN (83.5 %), 5 died during hospitalization, 6 were discharged on HPN (in-hospital incidence SBS-CIF: 8.9 %). Two SBS-CIF were resident in the Bologna metropolitan area (SBS-CIF incidence: 1.96 cases/10⁶ inhabitants).

Conclusions: Our study proposes a model to investigate the incidence of SBS-CIF in adults. The results provide new data on this hitherto unexplored area of SBS-CIF epidemiology and, importantly, offer a model for multicenter studies to further investigate the epidemiology of SBS-CIF on a national and international scale.

Keywords: Epidemiology; Home parenteral nutrition; Intestinal failure; Short bowel syndrome.