PP072 - CLINICAL CHARACTERISTICS, PARENTERAL NUTRITION COMPLICATIONS AND OUTCOMES IN ADULT PATIENTS WITH SHORT BOWEL SYNDROME: A 33-YEAR COHORT FROM A TERTIARY INTESTINAL REHABILITATION CENTER IN BRAZIL

PP072

CLINICAL CHARACTERISTICS, PARENTERAL NUTRITION COMPLICATIONS AND OUTCOMES IN ADULT PATIENTS WITH SHORT BOWEL SYNDROME: A 33-YEAR COHORT FROM A TERTIARY INTESTINAL REHABILITATION CENTER IN BRAZIL

M. Hollanda Martins da Rocha¹, P. P. Dal Bello^1,*, W. Macedo Lourenço de Faria¹, M. C. Gonçalves Dias¹, T. Uehara Sakô ¹, B. Andrade de Souza¹, A. M. Silva de Albuquerque ¹, A. Dong Won Lee¹

¹Division of Clinical Nutrition, Department of Gastroenterology, Hospital das Clínicas, University of São Paulo, HCFMUSP, São Paulo, Brazil

Rationale: The Intestinal Rehabilitation Program of HCFMUSP is a tertiary referral center for multidisciplinary management of adult patients with short bowel syndrome (SBS) and chronic intestinal failure, integrating clinical, nutritional and surgical care, including long-term parenteral nutrition (PN) and home PN.

Methods: Retrospective cohort of adult SBS patients followed between 1991–2024. Clinical characteristics, PN-related complications, intestinal transplantation and survival were analyzed. Data are presented as n (%) with 95% confidence intervals (CI).

Results: A total of 218 patients were included. Mesenteric thrombosis was the main etiology, frequently involving the superior mesenteric artery and leading to extensive resections. Most patients had chronic intestinal failure requiring long-term PN. PN-related complications were frequent: catheter-related bloodstream infection in 97 (44.3%; 95% CI 37.8–50.9), venous thrombosis in 39 (17.8%; 95% CI 13.2–23.3), cholestasis in 38 (17.4%; 95% CI 12.8–22.8) and osteopenia in 16 (7.3%; 95% CI 4.4–11.3). Eight patients underwent intestinal transplantation; rejection occurred in all cases (3 mild, 4 moderate, 1 severe). During follow-up, 57 deaths occurred (26.1%; 95% CI 21.0–32.6), mainly due to sepsis (13.8%), hydroelectrolytic disturbances (10.1%) and catheter-related infections (8.3%). Mean survival was 254.1 months (95% CI 218.9–289.4). Increasing age at entry to the intestinal rehabilitation program was associated with higher mortality risk (HR 1.029/year; 95% CI 1.012–1.046; p=0.001).

Conclusion: SBS represents a severe and heterogeneous condition requiring individualized multidisciplinary management. Specialized intestinal rehabilitation programs enable long-term care and identification of candidates for advanced therapies.

Disclosure of Interest: None declared