Outcome

The most important predictor of outcome in patients receiving home artificial nutritional support (enteral or parenteral) is the underlying disease. Therefore, mortality statistics strongly depend on the initial indications. Nevertheless, a few conclusions can be made. First, the complications associated with artificial nutritional support vary but are reported to be responsible for less than 3-5% of deaths. Second, the outcome is dependent not only on the type of disease but also on the stage of the disease (e.g., patients with advanced HIV who start HPN are only expected to survive a few months, whereas patients with less advanced disease are expected to survive longer). Third, the outcome of patients receiving HPN and HETF for a variety of conditions is available from the British Artificial Nutrition Survey (Table 6). For patients on HPN, overall mortality at lyear is 11%, with 16% returning to oral feeding and the majority continuing with HPN. Patients with Crohn's disease often have a good prognosis (with 4% mortality and 38% returning to oral feeding within 1 year). For patients on HETF, typically an older patient group, mortality

Table 6 Twelve-month outcomes for patients receiving home parenteral nutrition (HPN) and home enteral tube feeding (HETF)

Continuing Discontinuing

Continues (%) In hospital (%) Transferred to oral (%) Withdrawn/refused (%) Died (%)

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