HOME PARENTERAL-NUTRITION IN ADULTS - A MULTICENTER SURVEY IN EUROPE IN 1993

A retrospective survey was performed in 1994, involving 496 adult home parenteral nutrition (HPN) cases, newly enrolled in the year 1993 fro m 13 European countries from 75 centres. From the 8 countries having r egistered more than 80% of cases (423 patients), incidence and prevale nce ranged from 0.2 to 4.6 and 0.3 to 12.2 patients/10(6) population/y ear. In the patients studied, the diagnosis was cancer (42%), Crohn's disease (15%), vascular diseases (13%), radiation enteritis (8%), AIDS (4%) and other nonmalignant non-AIDS diseases (18%). Short bowel synd rome and intestinal obstruction were the two major indications for HPN in 31% and 22%, respectively. Seventy-three percent of the centres ha d a nutrition team. HPN was administered through a tunnelled venous ce ntral catheter in 73%, cyclical nocturnal infusions were used in 90% o f patients, and intravenous feeding was the sole source of nutrition i n 33%. Only 44% undertook HPN unaided. The present report indicates th at cancer has now become the main indication for HPN in Europe; there was, however, a heterogeneous distribution of diseases amongst the rep orting countries. The observed 9 (6-12)-month probability of survival was poor in AIDS (n = 8; 12%) and cancer patients (n = 78; 29%) but be tter for the other HPN indications (n = 115; 92%).