[Long-term follow-up of home parenteral nutrition at a general hospital: complications and quality of life].

OBJECTIVE

The present study assesses the septic, thrombotic and hepatic complications and also the quality of life of patients with home parenteral nutrition (NPD in its Spanish acronym).

METHODS

The case histories of patients treated with NPD at our hospital were collected for the period January, 1986, to January, 2001. We had 20 patients, mean age 48 +/- 14 years (mean +/- SD), with a total catheterization time of 16,292 days. The main causes of intestinal failure were mesenteric ischaemia and radical enteritis. Quality of life was assessed by means of the Sickness Impact Profile (SIP) and the Karnofsky Index (KI).

RESULTS

We found a catheter infection rate of 0.42 per 100 days of catheter, mostly produced by coagulase-negative staphylococci (63%). In 30% of the cases, it was necessary to remove the catheter, including in all cases produced by Candida. Cather occlusion rate was 0.05 per 100 days. Five patients presented an increase in transaminases and alkaline phosphatase, and one female patient developed cholestasis. Two patients died of NPD-related causes. The results of the quality of life analysis showed it was moderately affected, with SIP scores of 14.6 +/- 3.5 and KI results of 70 +/- 20 (mean +/- SD).

CONCLUSIONS

Home parenteral nutrition allows a greater survival in cases of intestinal failure. The most frequent complication is an infection of the catheter. The results of the quality of life analysis in our series reveal it was moderately affected in most cases.