Background and aim No marker to categorise the severity of chronic intestinal failure (CIF) has been developed. A 1-year international survey was carried out to investigate whether the European Society for Clinical Nutrition and Metabolism clinical classification of CIF, based on the type and volume of the intravenous supplementation (IVS), could be an indicator of CIF severity. Methods At baseline, participating home parenteral nutrition (HPN) centres enrolled all adults with ongoing CIF due to non-malignant disease; demographic data, body mass index, CIF mechanism, underlying disease, HPN duration and IVS category were recorded for each patient. The type of IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorised as <1, 1–2, 2–3 and >3 L/day. The severity of CIF was determined by patient outcome (still on HPN, weaned from HPN, deceased) and the occurrence of major HPN/CIF-related complications: intestinal failure-associated liver disease (IFALD), catheter-related venous thrombosis and catheter-related bloodstream infection (CRBSI). Results Fifty-one HPN centres included 2194 patients. The analysis showed that both IVS type and volume were independently associated with the odds of weaning from HPN (significantly higher for PN <1 L/day than for FE and all PN >1 L/day), patients’ death (lower for FE, p=0.079), presence of IFALD cholestasis/liver failure and occurrence of CRBSI (significantly higher for PN 2–3 and PN >3 L/day). Conclusions The type and volume of IVS required by patients with CIF could be indicators to categorise the severity of CIF in both clinical practice and research protocols.

中文翻译：

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静脉补充剂类型和剂量与慢性肠衰竭患者的 1 年结果和主要并发症有关

背景和目的 尚未开发出对慢性肠功能衰竭 (CIF) 的严重程度进行分类的标记。一项为期 1 年的国际调查旨在调查欧洲临床营养和代谢学会根据静脉补充剂 (IVS) 的类型和体积对 CIF 进行的临床分类是否可以作为 CIF 严重程度的指标。方法 在基线时，参与的家庭肠外营养 (HPN) 中心招募了所有因非恶性疾病而持续 CIF 的成年人；记录每位患者的人口统计学数据、体重指数、CIF 机制、基础疾病、HPN 持续时间和 IVS 类别。IVS 的类型分为单独液体和电解质 (FE) 或肠外营养混合物 (PN)。每周计算的平均每日 IVS 体积被归类为 <1、1-2、2–3 和 >3 L/天。CIF 的严重程度取决于患者的预后（仍使用 HPN、断奶、已故）和主要 HPN/CIF 相关并发症的发生：肠功能衰竭相关肝病 (IFALD)、导管相关静脉血栓形成和导管-相关血流感染 (CRBSI)。结果 51 个 HPN 中心包括 2194 名患者。分析表明，IVS 类型和体积均与 HPN 撤机几率独立相关（PN <1 L/天显着高于 FE 且所有 PN >1 L/天）、患者死亡（FE 较低， p=0.079)、IFALD 胆汁淤积/肝功能衰竭的存在和 CRBSI 的发生（PN 2-3 和 PN >3 L/天显着更高）。