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Trends in adult Home Parenteral Nutrition in Spain: 1992-2003 Tendencias en nutrición parenteral domiciliaria en pacientes adultos en Espa a: periodo 1992-2003

Keywords: Nutrición parenteral domiciliaria , Fracaso intestinal , Atención domiciliaria , Registro , Home parenteral nutrition , Intestinal failure , Home care , Registry

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There are very few data on trends in prevalence in home parenteral nutrition (HPN) in different countries. NADYA is the committee of the Spanish Society for Parenteral and Enteral Nutrition that takes care of the Spanish registry since 1992. Method: A 12-year retrospective study of the activity of the registry was performed.The data were extracted from the NADYA′s database as well as from the publications and abstracts reported on a yearly basis since 1992. Data on years 1993 and 1997-9 were not available. Results: Yearly prevalence has more than doubled to 86 patients since 1992. The number of reporting centres went up to 17 in 2003 (10 centres in 1992) As an average, the number of patients per centre is 5. The prevalence in 2003 was 2.15 patients per million inhabitants. There are trends to increasing age at the time of the first indication (42 years in 1992; 51 in 2003). Ischemic and thrombotic vascular diseases were the most common underlying diagnosis in adults. Tunnelled central venous catheters were chosen in 2/3 of the patients. Only around 17% of the patients received support from home delivery companies (11% in 1992) There were more than 1 complication per patient and year, mostly HPN-related. Conclusions: We found a steadily increase in the number of reported patients and reporting centres over time. Prevalence went up to 2.15 patients per million inhabitants in 2003, still far behind the figures from other western countries. The NADYA registry allows a close follow-up of the evolution of HPN in Spain. Existen pocos datos sobre la evolución de la prevalencia de nutrición parenteral domiciliaria (NPD) en cada país. El grupo de Nutrición Artificial Domiciliaria y Ambulatoria (NADYA) de SENPE se encarga del registro de pacientes en Espa a desde el a o 1992. Método: Se evaluó retrospectivamente la actividad del registro en el periodo 1992-2003. Los datos se extrajeron de la base de datos de NADYA así como de las comunicaciones a congresos y publicaciones realizadas por el grupo. No se disponen de datos de los a os 1993 y del periodo 1997-9. Resultados: La prevalencia anual se dobló desde 1992 hasta alcanzar los 86 pacientes en 2003. El número de centros que comunicaron pacientes pasó de 10 a 17 en este periodo. Como promedio, el número de pacientes por centro fue 5, aunque sólo un número reducido de centros controla más de 10 pacientes de forma habitual. La prevalencia de NPD en 2003 fue de 2,15 pacientes por millón de habitantes, con un ligero predominio de mujeres (1,6:1). La edad media al inicio de la NPD pasó de 42 a os en 1992 a 51 en 2003. L


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