P974 - HOME PARENTERAL NUTRITION IN CZECH REPUBLIC: THE NATIONAL REGISTRY (REDNUP)

P974

HOME PARENTERAL NUTRITION IN CZECH REPUBLIC: THE NATIONAL REGISTRY (REDNUP)

P. Tesinsky^1,*, J. Gojda¹, P. Wohl², K. Koudelkova¹, A. Ouradova¹ on behalf of Home Parenteral Nutrition Working Group, Czech Society for Clinical Nutrition and Intensive Metabolic Care (SKVIMP)

¹Dept. of Medicine, Faculty Hospital FNKV, 3rd Faculty of Medicine, Charles University, ²Center for Home Parenteral Nutrition and Diabetology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic

Rationale: Evolution in indications, syndromes, performance, weaning, and complications of HPN patients in Czech Republic based on updated data analysis of the National HPN Registry (REDNUP). 

Methods: Records have been collected for the time period 2007 – 2023. Catheter related sepsis, occlusions, and thrombotic complications are analysed for the time–to–event using the competing-risks regression. Other data is presented as median or mean with 95% CI (p< 0.05).

Results: The incidence rate of HPN is currently 1.98. Lifetime dependency is expected in 20% patients, potencial weaning in 40%, and 40% patients are palliative. Out of 1838 records (1.5 milion catheter days), SBS was present in 672 (36.6%), intestinal obstruction in 531 (28.9%), malabsorption in 274 (14.9%), and the rest of 361 patients (19.6%) was split between fistulas, dysphagia, or remained unspecified. Mobility was reported by 77.8%, economic activity and independence by 24.8% patients. A tunnelled catheter was used in 49.1%, PICC in 24.3%, and IV port in 19.8% patients. Pre-mixed AIO bags were used in 69.7%, and pharmacy-prepared admixtures in 24.7%. The CRS rate decreased from 0.84 in 2013 to 0.15 in 2022, catheter occlusions rate from 0.152 to 0.10, and thrombotic complications rate remains unchanged (0.05 to 0.04). The prevalence of metabolic bone disease and PNALD is 15.6 % and 22.3%. 28% patients achived intestinal autonomy within the first year, increasing up to 45% after 5 years. Survival rate is 62% in the first year, 45% at 5 years, and 35% at 10 years mark. Tedeglutide was indicated in 36 patients with a reduction of the daily HPN volume to 60.3% on average.

Conclusion: Prevalence and incidence of HPN patients is increasing over the last ten years. Majority of patients terminate HPN within the first year. Risk of CRS decreased significantly, catheter occlusion and thrombotic complications have a stable trend. Tedeglutide significantly reduced the PN volume.

Disclosure of Interest: None declared