Short‐Bowel Syndrome: Epidemiology, Hospitalization Trends, In‐Hospital Mortality, and Healthcare Utilization

Siddiqui, Mohamed Tausif; Al-Yaman, Wael; Singh, Amandeep; Kirby, Donald F.

doi:10.1002/jpen.2051

Cited by 32 publications

(32 citation statements)

References 101 publications

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“…Patients with intestinal insufficiency (INS) and intestinal failure (IF) are categorized under short bowel syndrome (SBS) [23]. Recent data suggest 10% of the patients with SBS are malnourished [22], and 20%e44.6% have had a weight loss [22,24]. A study from 2017 of patients with IF found that 69% were at severe nutritional risk and 27% at moderate nutritional risk [25], further patients with IF have significant higher risk of being malnourished [26].…”

Section: Introductionmentioning

confidence: 99%

Different GLIM criteria combinations change prevalence of malnutrition in patients with intestinal insufficiency or intestinal failure

Mikkelsen

Køhler²,

Østergaard³

et al. 2021

Clinical Nutrition ESPEN

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Background & aim: Due to lack of global consensus in diagnosing malnutrition, Global Leadership Initiative on Malnutrition (GLIM) has suggested the GLIM criteria based on etiological and phenotypical criteria. The aim of this study was to investigate the prevalence of malnutrition in patients with intestinal insufficiency (INS) or intestinal failure (IF) based on the different GLIM criteria combinations to diagnose malnutrition. Furthermore, the aim was to investigate the severity of malnutrition in the two patient groups. Methods: A cross-sectional study with INS patients on enteral nutrition and IF patients on home parenteral nutrition. We recorded age, gender, weight, height, fat free mass index (FFMI) by bioelectrical impedance analysis, handgrip strength (HGS), arm muscle circumference (AMC) and biochemical parameters: plasma albumin (p-alb) and plasma C-reactive protein (p-CRP). Further, we calculated Glasgow prognostic score (GPS) and body mass index (BMI). Statistics: T-test, Chi-square test and simple logistic regression analysis. Significance level: p < 0.05. Results: In total 277 INS and IF patients were included (age 59.5 ± 15.2 years, male 43,7%, BMI 22.1 ± 4.3 kg/m2). Groups were comparable according to number, age and gender but more IF patients had decreased BMI, p-alb, HGS and FFMI and increased CRP and GPS 1 or 2. Prevalence of malnutrition using GPS 1 or 2 combined with BMI, FFMI or HGS was 22.6%, 23.4%, 26.3% for INS, respectively (p ¼ 0.756) and 40.7%, 40.0%, 59.3% for IF, respectively (p ¼ 0.001). Agreement between the criteria combinations were: 8.0% for INS and 25.7% for IF. Significantly more with IF was diagnosed with severe malnutrition as compared to no malnutrition (43 vs. 26, p ¼ 0.012, OR 2.1 [CI95% 1.2e3.8]), but only a tendency in the group with moderate malnutrition as compared to no malnutrition (27 vs. 22, p ¼ 0.180, OR 1.6 [CI95% 0.8e3.0]) Conclusion: We found both prevalence and severity of malnutrition to be higher in IF than INS patients. GLIM-criteria were able to identify approximately same prevalence of malnutrition in INS but not in IF, when combining GPS 1 or 2 with BMI, FFMI and HGS. However, the agreement was poor in both groups. Consequently, further validation of GLIM is needed -including association to clinical outcome in lack of a gold standard.

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Section: Introductionmentioning

confidence: 99%

Different GLIM criteria combinations change prevalence of malnutrition in patients with intestinal insufficiency or intestinal failure

Mikkelsen

Køhler²,

Østergaard³

et al. 2021

Clinical Nutrition ESPEN

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“…SBS‐IF is rare, with an estimated prevalence in adults of 0.4–25.0 per million in the United States and in Europe, with prevalence increasing 6–9 . Recent improvements in management (notably owing to improved understanding of physiological changes and how to augment them to gain enteral autonomy) have improved the historically high morbidity and mortality of SBS‐IF 10,11 …”

Section: Introductionmentioning

confidence: 99%

Management of short‐bowel syndrome: A survey of unmet educational needs among healthcare providers

Belcher

Mercer

Raphael

et al. 2022

J Parenter Enteral Nutr

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Background: Management of short-bowel syndrome with intestinal failure (SBS-IF) is complex and requires a multidisciplinary approach. Because of the rarity of SBS-IF, healthcare professionals (HCPs) often lack clinical experience with the disease and may benefit from education regarding SBS-IF and its management. This study identified unmet educational needs related to the management of patients with SBS-IF.Methods: This was a prospective, web-based survey (December 2019-January 2020) in which a series of clinical questions were posed to US HCPs after presenting three standardized SBS-IF cases to assess current practice patterns. HCPs were then asked a series of questions to identify potential knowledge gaps and unmet educational needs relating to SBS-IF management.Results: Overall, 558 HCPs completed the survey, with 12%-38% having a formal SBS-IF multidisciplinary team currently available to make treatment decisions within their institution. Clinicians involved in care included gastroenterologists (93%), registered dietitians (79%), gastroenterology nurse practitioners and physician assistants (37%), registered nurses (43%), social workers (45%), and psychologists/ psychiatrists (27%). There was underuse of published guidelines and limited understanding of the course of intestinal adaptation. Responses to the clinical scenarios highlighted disparities in SBS-IF care delivery, including diagnosis, management goals, medications prescribed, and nutrition practices. Conclusions: Future SBS-IF educational interventions for HCPs should aim to improve awareness and understanding of the disease, facilitate timely diagnosis, and standardize management practices to ensure patients receive optimal interdisciplinary care as widely as possible.

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“…short bowel syndrome (SBS), and is connected to high mortality rates 1 . For LC patients, the prevalence of MN is indicated with up to 90% 2 ; for patients suffering from SBS with around 10 to 40% 3 . Disease-related MN is closely related to mild, chronic inflammation 4 .…”

Section: Introductionmentioning

confidence: 99%

In silicoInvestigation of Molecular Networks Linking Gastrointestinal Diseases, Malnutrition, and Sarcopenia

Ehlers

Bannert

Stanke

et al. 2022

Preprint

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Malnutrition is a common primary or secondary complication in gastrointestinal diseases. The patient's nutritional status also influences muscle mass and function, which can be impaired up to the degree of sarcopenia. The molecular interactions in diseases leading to sarcopenia are complex and multifaceted, affecting muscle physiology, the intestine (nutrition), and the liver at different levels. Although extensive knowledge of individual molecular factors is available, their regulatory interplay is not yet fully understood. A comprehensive overall picture of pathological mechanisms and resulting phenotypes is lacking. In silico approaches that convert existing knowledge into computationally readable formats can help to unravel such complex systems. We compiled available experimental evidence for molecular interactions involved in the development of sarcopenia into a knowledge base, referred to as the Sarcopenia Map. By including specific diseases, namely liver cirrhosis, and intestinal dysfunction, and considering their effects on nutritional status and blood secretome, we investigated their contribution to the development of sarcopenia. The Sarcopenia Map is publicly available as an open-source, interactive online resource, providing tools that allow users to explore the information on the map and perform in silico perturbation experiments.

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Short‐Bowel Syndrome: Epidemiology, Hospitalization Trends, In‐Hospital Mortality, and Healthcare Utilization

Cited by 32 publications

References 101 publications

Different GLIM criteria combinations change prevalence of malnutrition in patients with intestinal insufficiency or intestinal failure

Different GLIM criteria combinations change prevalence of malnutrition in patients with intestinal insufficiency or intestinal failure

Management of short‐bowel syndrome: A survey of unmet educational needs among healthcare providers

In silicoInvestigation of Molecular Networks Linking Gastrointestinal Diseases, Malnutrition, and Sarcopenia

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