Original ArticlePredictors of Enteral Autonomy in Children with Intestinal Failure: A Multicenter Cohort Study
Section snippets
Methods
We performed a multicenter retrospective cohort study among the PIFCon. The group was initiated in June 2006 as a collaboration among 14 sites with established multidisciplinary programs for treatment of pediatric IF; 9 of the 14 sites also had affiliated intestinal transplantation (ITx) programs. After Institutional Review Board approval was obtained from each participating center, records of patients who met inclusion criteria were reviewed retrospectively. Infants with IF were included if
Results
Select patient demographic and baseline characteristics are summarized in Table I. The 272 infants who met study inclusion criteria were followed for a median of nearly 3 years. Complete enteral autonomy was achieved in 118 (43%) by the end of the study follow-up period; 36 patients (13%) remained partially or exclusively PN dependent, and 118 (43%) patients died (n = 58), underwent intestinal/multivisceral transplantation (n = 50), or underwent transplant and then died (n = 10). The cumulative
Discussion
In this multicenter retrospective cohort of a large number of infants with IF, we found that almost one-half of all patients achieved enteral autonomy within the nearly 3 years of follow-up. Medical care at a nontransplantation IF program, underlying NEC, and a preserved ICV were all independently associated with enteral autonomy. A second multivariable model confirmed that longer measured RSB length also was an independent predictor of successful weaning from PN.
Our finding of a rate of
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Supported by the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (1 R21 DK081059-01). C.D. was funded in part from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K24HD058795 and K24DK104676-06). The authors declare no conflicts of interest.
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A list of members of the Pediatric Intestinal Failure Consortium is available at www.jpeds.com (Appendix).