Evaluation of survival outcomes in patients receiving palliative home parenteral nutrition: a retrospective observational study
Objective Intestinal failure in advanced malignancy is most commonly due to mechanical bowel obstruction. Palliative home parenteral nutrition (HPN) is an option for such patients to meet their nutritional needs. However, there are limited data on overall survival and predictive factors. This study...
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BMJ Publishing Group
2025-08-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/12/1/e001822.full |
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| author | Charlotte Rutter Nicola Wilson Dunecan Massey Jeremy Woodward Emma Mckenzie Kristie Huirong Fan Pinal S Patel Rebecca Maddison |
| author_facet | Charlotte Rutter Nicola Wilson Dunecan Massey Jeremy Woodward Emma Mckenzie Kristie Huirong Fan Pinal S Patel Rebecca Maddison |
| author_sort | Charlotte Rutter |
| collection | DOAJ |
| description | Objective Intestinal failure in advanced malignancy is most commonly due to mechanical bowel obstruction. Palliative home parenteral nutrition (HPN) is an option for such patients to meet their nutritional needs. However, there are limited data on overall survival and predictive factors. This study aimed to evaluate the survival of patients receiving palliative HPN and the impact of patient factors on survival.Methods This is a single-centre retrospective observational study of patients referred for palliative HPN from 1 January 2020 to 19 November 2024 at the Cambridge University Hospitals NHS Foundation Trust. Demographic, nutritional and medical data were analysed. Survival rates were compared using Kaplan-Meier curves and Cox regression.Results 84 patients were referred and 77 were discharged with HPN (median age was 60.9 years (IQR: 51.3–70.4), female 77%). 78% of the underlying primary malignancies were gynaecological and gastrointestinal. Malignant bowel obstruction was the main indication for HPN (86%). Eastern Cooperative Oncology Group performance status (PS) scores were ≤2 in 82% of patients and 75% had an estimated prognosis of >3 months. Median survival was 58 days (IQR 31–108) with a 3-month mortality of 69%. There was no statistical difference in survival by PS, estimated prognosis, underlying malignancy or modified Glasgow Prognostic Score (mGPS).Conclusions The overall survival in our study is modest. PS, prognosis, mGPS or tumour type did not show a significant impact on survival. This highlights the challenges in artificial nutrition and emphasises the role of a multidisciplinary team in the care of these patients. |
| format | Article |
| id | doaj-art-3bf945cb8f194bd2bb35784475d22169 |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open Gastroenterology |
| spelling | doaj-art-3bf945cb8f194bd2bb35784475d221692025-08-21T02:30:11ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742025-08-0112110.1136/bmjgast-2025-001822Evaluation of survival outcomes in patients receiving palliative home parenteral nutrition: a retrospective observational studyCharlotte Rutter0Nicola Wilson1Dunecan Massey2Jeremy Woodward3Emma Mckenzie4Kristie Huirong Fan5Pinal S Patel6Rebecca Maddison71 Cambridge Centre for Intestinal Rehabilitation and Transplant, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK1 Cambridge Centre for Intestinal Rehabilitation and Transplant, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK1 Cambridge Centre for Intestinal Rehabilitation and Transplant, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK1 Cambridge Centre for Intestinal Rehabilitation and Transplant, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK1 Cambridge Centre for Intestinal Rehabilitation and Transplant, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK1 Cambridge Centre for Intestinal Rehabilitation and Transplant, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK1 Cambridge Centre for Intestinal Rehabilitation and Transplant, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK1 Cambridge Centre for Intestinal Rehabilitation and Transplant, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UKObjective Intestinal failure in advanced malignancy is most commonly due to mechanical bowel obstruction. Palliative home parenteral nutrition (HPN) is an option for such patients to meet their nutritional needs. However, there are limited data on overall survival and predictive factors. This study aimed to evaluate the survival of patients receiving palliative HPN and the impact of patient factors on survival.Methods This is a single-centre retrospective observational study of patients referred for palliative HPN from 1 January 2020 to 19 November 2024 at the Cambridge University Hospitals NHS Foundation Trust. Demographic, nutritional and medical data were analysed. Survival rates were compared using Kaplan-Meier curves and Cox regression.Results 84 patients were referred and 77 were discharged with HPN (median age was 60.9 years (IQR: 51.3–70.4), female 77%). 78% of the underlying primary malignancies were gynaecological and gastrointestinal. Malignant bowel obstruction was the main indication for HPN (86%). Eastern Cooperative Oncology Group performance status (PS) scores were ≤2 in 82% of patients and 75% had an estimated prognosis of >3 months. Median survival was 58 days (IQR 31–108) with a 3-month mortality of 69%. There was no statistical difference in survival by PS, estimated prognosis, underlying malignancy or modified Glasgow Prognostic Score (mGPS).Conclusions The overall survival in our study is modest. PS, prognosis, mGPS or tumour type did not show a significant impact on survival. This highlights the challenges in artificial nutrition and emphasises the role of a multidisciplinary team in the care of these patients.https://bmjopengastro.bmj.com/content/12/1/e001822.full |
| spellingShingle | Charlotte Rutter Nicola Wilson Dunecan Massey Jeremy Woodward Emma Mckenzie Kristie Huirong Fan Pinal S Patel Rebecca Maddison Evaluation of survival outcomes in patients receiving palliative home parenteral nutrition: a retrospective observational study BMJ Open Gastroenterology |
| title | Evaluation of survival outcomes in patients receiving palliative home parenteral nutrition: a retrospective observational study |
| title_full | Evaluation of survival outcomes in patients receiving palliative home parenteral nutrition: a retrospective observational study |
| title_fullStr | Evaluation of survival outcomes in patients receiving palliative home parenteral nutrition: a retrospective observational study |
| title_full_unstemmed | Evaluation of survival outcomes in patients receiving palliative home parenteral nutrition: a retrospective observational study |
| title_short | Evaluation of survival outcomes in patients receiving palliative home parenteral nutrition: a retrospective observational study |
| title_sort | evaluation of survival outcomes in patients receiving palliative home parenteral nutrition a retrospective observational study |
| url | https://bmjopengastro.bmj.com/content/12/1/e001822.full |
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