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Regional trends in paediatric home enteral tube feeding 1997–2009
  1. R Ardill1,
  2. S Lawrence1,
  3. HM Lee1,
  4. C Paxton1,
  5. L Eyles2,
  6. DC Wilson3
  1. 1Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, UK
  2. 2Community Enteral Nutrition Team, NHS Lothian, Edinburgh, UK
  3. 3Child Life and Health, University of Edinburgh, Edinburgh, UK

Abstract

Introduction Home enteral tube feeding (HETF) is increasingly used to support patients with chronic childhood conditions, but with little data published regarding the prevalence and outcome of paediatric HETF. The British Artificial Nutrition Survey report of 2008 estimated that BANS captured only 59% of paediatric HETF patients.

Aims (1) To identify the true prevalence and incidence of children receiving HETF during a 13-year period after the introduction of a regional nutrition support team (NST). (2) To describe the characteristics of these children including sex, route of feeding and duration of HETF. (3) To describe outcome of HETF.

Methods Retrospective review of all aged <19 years commencing HETF in a defined UK region from 1 May 1997 to 1 May 2009 (stable population of 1.25 million people). Data were obtained from the enteral feeding database (this database collates data from all district general hospitals and the regional tertiary centre), hospital computerised records, and medical and dietetic notes where necessary.

Results 730 patients (51% male) were identified. Point prevalence increased from 65 in May 5 1997 to 186 in May 5 2001, followed by a period of stability, and then a further increase from 2008, with current prevalence on May 5 2009 the highest ever at 214. The incidence of new HETF starts rose from 1997 to 2000, again with a period of stability until the increase from 2007 to 2008. Median (range) age at HETF start was 2.1 (0.0–18.9) years. Median (range) length of time on HETF was 2.6 (0.1–21.2) years. Only 4% of patients required jejunal feeding. At study end, 28% of patients remained on active HETF, 10% were transferred to adult services on HETF, 41% of patients returned to full oral feeds, 8% left the region on HETF and 13% died on HETF (none due to HETF complications).

Conclusion Following formation of a regional NST, a large number of children requiring HETF were identified, resulting in rapid increase in prevalence of patients on HETF, followed by stability and then a more recent increase in the last 2 years. A minority of patients return to full oral feeding. These trends provide valuable information to aid development and funding of HETF services.

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