PP253 - THE EVOLVING PROFILE OF ADULT PATIENTS WITH CHRONIC INTESTINAL FAILURE DUE TO SHORT BOWEL SYNDROME AT THE START OF PARENTERAL SUPPORT

PP253

THE EVOLVING PROFILE OF ADULT PATIENTS WITH CHRONIC INTESTINAL FAILURE DUE TO SHORT BOWEL SYNDROME AT THE START OF PARENTERAL SUPPORT

F. D. Merlo¹, M. Ossola¹, U. Aimasso¹, L. Cravero¹, V. Giordano², S. Bo^2,*

¹Clinical Nutrition Unit, ²University of Torino, Torino, Italy

Rationale: Chronic intestinal failure (CIF) requires long-term parenteral support (PS), most commonly due to short bowel syndrome (SBS). Advances in care have improved outcomes, but whether the clinical profile of patients with CIF-SBS at PS initiation has changed over time remains unclear. We assessed temporal changes in demographic, clinical, and biochemical characteristics of these patients at PS initiation over nearly four decades.

Methods: We retrospectively analyzed data from adult patients with CIF-SBS managed between 1985 and 2024 at the AOU Città della Salute e della Scienza (Torino, Italy) a tertiary referral center. Patients were stratified into tertiles according to PS initiation (≤2005, 2006–2014, ≥2015). Clinical, anatomical, etiological, and biochemical variables were compared across groups.

Results: Among 251 included patients, residual small bowel length increased significantly over time (67±48 vs 101±54 vs 102±54 cm; p<0.001). The anatomical distribution shifted toward type 1 SBS (19% vs 45% vs 51%) with a decline in type 2 configurations (50% vs 35% vs 27%; p<0.001). Etiology evolved from predominantly mesenteric ischemia (51% to 21%) to increased oncologic surgery (7% to 46%) and Crohn’s disease (9% to 22%) (p<0.001). The proportion of patients undergoing ≥3 prior abdominal surgeries rose markedly (14% vs 18% vs 38%; p<0.001). Age, sex, BMI, and ileocecal valve prevalence remained stable. Liver enzymes and bilirubin decreased significantly over time (AST p=0.011; ALT p<0.001; bilirubin p=0.007), while magnesium, phosphate, and vitamin D levels improved (all p≤0.019). 

Conclusion: The profile of patients initiating PS for CIF-SBS has substantially evolved, with changes in anatomy, etiology, and surgical burden, alongside improved biochemical status. These findings have implications for risk stratification and long-term management.

Disclosure of Interest: None declared