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      Pediatric Short Bowel Syndrome: Real-World Evidence on Incidence and Hospital Resource Use From a Finnish Data Lake

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          Abstract

          Objectives:

          Little is known about the epidemiology and healthcare burden of pediatric intestinal failure (IF). We aimed to assess the incidence, prevalence, healthcare resource utilization (HCRU), and related costs of pediatric short bowel syndrome (SBS) using follow-up data from the largest hospital district in Finland.

          Methods:

          This retrospective registry study utilized electronic healthcare data covering all pediatric patients with SBS-IF born between 2010 and 2019 at the Hospital District of Helsinki and Uusimaa in Finland. Patients were followed from birth until the end of 2020 and compared to control patients, all from the same hospital system.

          Results:

          In total, 38 patients with SBS-IF and 1:5 matched controls were included, with median follow-up time of almost 6 years from birth. Over half of the patients were born early preterm (gestational age ≤30 weeks). The incidence of pediatric SBS-IF was 24 per 100,000 live births. The HCRU was higher compared to controls and most of the inpatient days incurred during the first year of the SBS-IF patients’ life. The average hospital-based HCRU costs were €221,000 for the first year and €57,000 for whole follow-up annually. The costs were higher for the early preterm patients and accumulated mainly from inpatient days.

          Conclusions:

          SBS-IF is a rare disease with a relatively low number of patients treated at each hospital district. The burden on the hospital system, as well as the patient’s family, is especially high at the onset as the newborns with SBS-IF spend a significant part of their first year of life in the hospital.

          Abstract

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          Most cited references31

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          Long-term parenteral nutritional support and intestinal adaptation in children with short bowel syndrome: a 25-year experience.

          To analyze the outcome of children with short bowel syndrome (SBS) who required long-term parenteral nutrition (PN). Retrospective analysis of children (n=78) with SBS who required PN >3 months from 1975 to 2000. univariate analysis, Kaplan-Meier method, and Cox proportional regression model were used. We identified 78 patients. Survival was better with small bowel length (SBL) >38 cm, intact ileocecal valve (ICV), intact colon, takedown surgery after ostomy (all P 50% of colon was resected (P 15 cm without ICV have a chance of intestinal adaptation.
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            Neonatal short bowel syndrome: population-based estimates of incidence and mortality rates.

            Congenital or acquired neonatal short bowel syndrome (SBS) carries significant morbidity and mortality rates. No accurate population estimates of incidence and mortality exist because of differences in definition, follow-up, and regional referral patterns. A retrospective cohort study was performed involving 175 surgical neonates admitted to our institution from January 1, 1997 to December 31, 1999 and followed up until July 1, 2001. Institution and population-based estimates of incidence and mortality were performed using postcensal population figures (1997) from Statistics Canada. The overall incidence of SBS was 22.1 per 1,000 neonatal intensive care unit (NICU) admissions (95% CI = 15.3, 28.9) and 24.5 per 100,000 live births (95% CI = 12.1, 36.9). The incidence was much greater in premature infants (less than 37 weeks). The SBS case fatality rate was 37.5% (95% CI = 22.5, 52.5) and the cause-specific and proportional mortality rates (for children less than 4 years old) were 2.0 of 100,000 population per year (0.4 to 3.6/100,000/year) and 1.4% (0.3% to 2.6%), respectively. Patients with neonatal SBS pose a complex management challenge and are responsible for a significant cost to the health care system. To our knowledge, this study represents the first population-based estimates for neonatal SBS incidence and mortality rates. Accurate estimates will assist clinicians in counseling parents, allocating resources, and planning clinical trials.
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              Pediatric Intestinal Failure

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                Author and article information

                Journal
                J Pediatr Gastroenterol Nutr
                J Pediatr Gastroenterol Nutr
                MPG
                Journal of Pediatric Gastroenterology and Nutrition
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0277-2116
                1536-4801
                25 July 2023
                October 2023
                : 77
                : 4
                : 479-485
                Affiliations
                From [* ]Takeda Oy, Helsinki, Finland
                the []Division of Pharmaceutical Technology and Chemistry, Industrial Pharmacy, University of Helsinki, Helsinki, Finland
                []Medaffcon Oy, Espoo, Finland
                the [§ ]Pediatric Gastroenterology Unit, Helsinki University Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
                the []Section of Pediatric Surgery, Pediatric Liver and Gut Research Group, Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
                the []Department of Women’s Health, Karolinska Institute, Solna, Sweden.
                Author notes
                Address correspondence and reprint requests to Liisa Ukkola-Vuoti, PhD, Medaffcon Oy, Metsänneidonkuja 8, 02130 Espoo, Finland (e-mail: liisa.ukkola-vuoti@ 123456medaffcon.fi ).
                Article
                00009
                10.1097/MPG.0000000000003894
                10501354
                37490606
                54832c45-1f6e-4b15-92fe-34fe51ea2598
                Copyright © 2023 The Author(s). Published by Wolters Kluwer on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : 28 February 2023
                : 11 July 2023
                Funding
                Funded by: Takeda
                Award Recipient : Not Applicable
                Categories
                Original Articles: Gastroenterology
                Custom metadata
                TRUE
                T

                burden of disease,pediatrics,prevalence,registry study,sbs-if

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