JPEN J Parenter Enteral Nu. 2021 Jul;45(5):926-932.doi: 10.1002/jpen.1958. Epub 2020 Jul 17.

Cecilie Bagi Nordsten ¹, Stig Molsted ², Louise Bangsgaard ¹, Kristian A Fuglsang ¹, Christopher F Brandt ¹, Mads J Niemann ³, Palle B Jeppesen ¹

Author information

¹Department of Gastroenterology and Hepatology, Rigshospitalet, Copenhagen, Denmark.

²Department of Clinical Research, Nordsjaellands Hospital, Hilleroed, Denmark.

³Department of Anesthesiology, The Copenhagen Muscle Research Centre, Rigshospitalet, Copenhagen, Denmark.

Abstract

Background: Aim was to investigate the association between quality of life (QoL), bowel anatomy, and the need for home parenteral support (HPS) volume in patients with nonmalignant short-bowel syndrome (SBS) and intestinal failure (IF).

Methods: The SBS-QoL scale was used in a cross-sectional study of 95 nonmalignant SBS-IF patients. Sum QoL scores (0: best, 170: worst) were calculated. Patients were defined as having a small bowel (≤200 cm), and patients with jejunostomy or ileostomy were subclassified based on functional small-bowel length (cm) into 4 anatomy subgroups: 1a-1d (0-49, 50-99, 100-149, 150-200 cm, respectively). Multiple linear regression analyses explored associations between QoL, patient groups, and HPS volume, adjusting for age, sex, body mass index, and education.

Results: Complete data were obtained from 60 patients. HPS volume was associated with a worse SBS-QoL score (L/d, β = 7.91; SE = 3.90; P = .048), but male sex associated with improvement (β = -26.28; SE = 11.06; P = .021). No differences in sum QoL were seen between the benign SBS-IF subgroups 1a-d (P = .210). Multivariate regression analyses showed that patients with a small-bowel stoma, a small-bowel length <50 cm was associated with a significantly worse/higher SBS-QoL score compared with a length >50 cm.

Conclusion: In patients with benign SBS-IF, high HPS volume was associated with poor QoL. Also, jejunostomy or ileostomy with small-bowel length <50 cm was associated with impaired QoL. These findings support rehabilitation strategies that reduce fecal losses and decrease HPS needs.