Short article: Frequency, pathophysiology, and clinical classification of intestinal failure type II and III at a tertiary referral center

Eur J Gastroenterol Hepatol. 2019 Jan;31(1):123-127. doi: 10.1097/MEG.0000000000001280.

Abstract

Objective: Intestinal failure (IF) is a complex disease that is gaining significance and attention throughout the world. In Mexico, there are no available data on this condition. The aim of this study was to determine the frequency and characteristics of patients with IF type II and III hospitalized at a tertiary referral center in our country.

Patients and methods: A cross-sectional study was carried out from August 2016 to July 2017. Adult patients hospitalized in noncritical areas with a recent diagnosis of IF type II or III according to the European Society for Clinical Nutrition and Metabolism classification were included. Demographic, anthropometric, nutritional therapy, biochemical, and clinical characteristics were registered. Nutritional risk was determined by the Nutritional Risk Score 2002.

Results: During the study, 4144 patients were admitted to noncritical areas; 21 (5/1000) of these patients were included. The mean age of the patients was 51±18.8 years, and the mean BMI was 17.6±5.5 kg/m. Fifteen (71.5%) patients were diagnosed with IF type II and six (28.5%) with IF type III. The primary diagnosis was surgical complications in seven (33.3%) of the cases and the principal pathophysiological mechanism was short bowel syndrome in nine (42.8%) patients. The most frequent (37%) clinical classification was D2: more than 20 kcal/kg/day and 1001-2000 ml/day and parenteral nutrition and PN2: 1001-2000 ml/day (52.3%) based on the modified European Society for Clinical Nutrition and Metabolism clinical classification.

Conclusion: In this study, a high frequency of IF was found; surgical complications and short bowel syndrome were the main mechanisms involved, and D2 was the most frequent clinical category.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Energy Intake
  • Female
  • Humans
  • Intestinal Absorption*
  • Malabsorption Syndromes / diagnosis*
  • Malabsorption Syndromes / epidemiology
  • Malabsorption Syndromes / physiopathology*
  • Malabsorption Syndromes / therapy
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Nutritional Status*
  • Parenteral Nutrition
  • Short Bowel Syndrome / diagnosis
  • Short Bowel Syndrome / epidemiology*
  • Short Bowel Syndrome / physiopathology
  • Surgical Procedures, Operative / adverse effects*
  • Tertiary Care Centers*
  • Treatment Outcome