Objective: The study was aimed to describe clinical characteristics and evaluate our health care performance in infants with short bowelsyndrome (SBS) requiring long-term parenteral nutrition (PN) against international levels. This would help position us and identify gaps for developing quality improvement plans.
Methods: Infants with SBS requiring long-term PN were consecutively enrolled. Clinical data including underlying diseases, remaining intestinal length, presence of ileocecal valve, complications, enterostomy closure, PN data, presence of PN-associated liver disease (PNALD), length of stay, and hospital expenses were systematically recorded.
Results: Eleven infants, 6 males and 5 females, were enrolled for analysis. 10 of 11 could be discharged after the first hospitalization with the median duration of admission of 3.33 months [IQR 2.77, 8.83]. One infant with necrotizing enterocolitis (NEC) died from enterocolitis and sepsis at the age of 2.8 years after being discharged home at the local hospital, whereas one patient with diagnosis of midgut volvulus with jejunal atresia has remained hospitalized and PN-dependent at the time of analysis. Majority of the cases(64%) were NEC. Most common complication was PNALD. Ten patients had enterostomy performed, in which the median duration of ostomy was 63 days [IQR 52, 92]. The median time to achieve full enteral nutrition was 39.5 days [IQR 17, 82]. The median length of stay and total first admission cost were 104 days and 1,100,408 baht, respectively.
Conclusion: Our medical center has recently provided international standard of care for infants with SBS requiring long-term PN leading to high standard quality of life. Although the mortality rate can be dramatically reduced compared to those in the past two decades, the next step quality improvement should be emphasized on socio-economic issues
