Home parenteral nutrition in adults: a European multicentre survey in 1997

A retrospective survey on home parenteral nutrition (HPN) in Europe was per formed from January to December 1997. Data were compared to a similar study performed in 1993. A questionnaire of HPN practice was designed by the members of the ESPEN-HA N group. This involved adult patients (older than 16 years) newly registere d in an HPN program between 1 January and 31 December 1997 and included: nu mber of patients, underlying diseases and a 6-12 month outcome. Incidence a nd prevalence (at 1.1.1998) of adult HPN were calculated according to the e stimated total population in 1997 for the countries in which more than 80% of HPN patients were reported. A total of 494 patients were registered in 73 centres from nine countries ( Belgium (B), Denmark (D), France (F), Poland (P), Spain (S), Sweden (Sw), U nited Kingdom (UK), The Netherlands (N) and Germany (G). The underlying dis eases for HPN in 494 patients were cancer (39%), Crohn's (19%), vascular di seases (15%), radiation enteritis (7%), AIDS (2%), other diseases with inte stinal failure (18%). Incidence (patients/million inhabitants/year) were in N (3), F. (2.9), D. (2.8), B. (2.6), UK (1.2), S (0.7) and P (0.36), respe ctively. Prevalence were in D, (12.7). U.K. (3.7), N. (3.7), F (3.6), B (3. 0), P (1.1), S (0.65). After this 6-12 months follow-up (n=284), the mortal ity was respectively 4% in Crohn's disease, 13% in vascular diseases, 16% i n others, 21% in radiaton enteritis, 34% in AIDS, 74% in cancer. Incidences and prevalences modestly increased in these seven European count ries in 1997 in comparison to 1993. The percentages of underlying diseases in these countries remained similar except for AIDS that significantly decr eased (from 7% to 2%). Outcomes did not significantly differ in the 4-year period except for AIDS (34% instead of 88% mortality) and could have been r elated to newer, more efficacious therapy.