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PWE-234 Management and outcomes of intestinal failure in a district general hospital setting
  1. C Tamura1,
  2. R Kalaiselvan1,
  3. A Kenyon1,
  4. D Smith1,
  5. N Sarwar2,
  6. CJ Walsh1
  1. 1General Surgery
  2. 2Gastroenterology, Arrowe Park Hospital, Wirral, UK

Abstract

Introduction Centralisation of intestinal failure (IF) services is being considered. It will not be possible to manage all patients with type 2 IF in national centres and many patients will need to be managed regionally. We have audited our practice of type 2 and 3 IF with respect to aetiology, management and outcomes in a DGH setting.

Method Retrospective analysis of consecutive patients admitted with type 2/3 IF requiring parenteral nutrition (PN) for > 28 days between 01/09/2009–31/07/2014 was done from prospectively maintained database and cross-referenced with case notes (electronic and paper). Data are represented as median (range).

Results There were 84 patients (45 women) admitted during the study period. The median age was 68 (20–90) years.

Abstract PWE-234 Table 1

PN details Patients were managed on PN for a median of 65 (29–728) days while being an in-patient. The catheter related infection rate was 0.16 CRBI /1000 catheter-days. PN was administered by peripherally inserted central catheters by a nurse led service.

Outcome Nutritional autonomy was achieved following conservative management in 17 (20%) patients. 46 (55%) underwent one-stage (n = 24) or two-stage (n = 22) surgical procedures and achieved nutritional autonomy. 8(10%) required home parenteral nutrition of which 6 were palliative patients who were discharged to hospice and 2 were referred to national IF centres. 12(14%) with type 2 IF and 1 (1%) with type 3 IF died in hospital.

At a median follow-up of 479 (19–1885) days, 18 (21%) with type 2 IF and 6 (7%) with type 3 IF died.

Conclusion Sepsis management and safe PN administration is the key to managing patients with IF and can be done in regional units.

Disclosure of interest None Declared.

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