Am J Surg. 2024 Sep 14:238:115972. doi: 10.1016/j.amjsurg.2024.115972. Online ahead of print.

Jon S Thompson ¹, Fedja A Rochling ², Elizabeth Lyden ³, Shaheed Merani ⁴, Luciano Vargas ⁴, Wendy J Grant ⁴, Alan N Langnas ⁴, David F Mercer ⁴

Author information

¹Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, USA. Electronic address: jthompso@unmc.edu.

²Department of Medicine, University of Nebraska Medical Center Omaha, Nebraska, USA.

³College of Public Health, University of Nebraska Medical Center Omaha, Nebraska, USA.

⁴Department of Surgery, University of Nebraska Medical Center Omaha, Nebraska, USA.

Abstract

Background: Textbook outcome (TO) is a single composite score representing ideal care for a procedure or medical condition. Short bowel syndrome (SBS) patients are at high risk for complications and death. Our aim was to determine the incidence of and predictive factors for a TO in SBS patients.

Methods: 515 adults with SBS were followed for 12 months after initial hospital discharge for SBS. TO was defined based on eight outcome parameters. Demographic data, intestinal anatomy, and nutritional outcome were compared in patients with and without TO.

Results: 78 (15 ?%) patients had a TO. The frequency of the different components of TO were: PN ?< ?1 year (39 ?%), BMI >18.5 ?kg/m² (89 ?%), no stoma (59 ?%), no surgical intervention (71 ?%), no hospital readmission (56 ?%), no vascular access infection (62 ?%), absence of end stage liver disease (96 ?%), and survival (97 ?%). Intestinal remnant length and anatomy type were predictive of a TO.

Conclusions: A TO is achieved in 15 ?% SBS patients using the selected criteria. This is largely attributable to continued need for PN. Intestinal length and anatomy were independent predictors of TO.