1
|
Zagierski M, Górska A, Zagierska A, Augustyńska J, Seweryn M, Szlagatys-Sidorkiewicz A. Home Enteral Nutrition in Patients with Cerebral Palsy in the Years 2012-2022: A Longitudinal Analysis of Data from the National Health Fund of Poland. Nutrients 2024; 16:2394. [PMID: 39125275 PMCID: PMC11314170 DOI: 10.3390/nu16152394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/17/2024] [Accepted: 07/18/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Cerebral palsy (CP) often correlates with a higher risk of malnutrition, negatively affecting the quality of life of patients and their families. Enteral nutrition via a feeding tube should be considered to improve the nutritional status of CP patients. To date, there has been no nationwide registry of patients with CP in Poland. This study aimed to assess the prevalence of home enteral nutrition (HEN) provision in pediatric and adult patients with CP. METHODS We retrospectively analyzed data from the Polish National Health Fund (NFZ) on the provision of HEN in patients with CP in 2012-2022. A specially designed and validated questionnaire was sent to the 16 regional branches of NFZ. RESULTS Completed questionnaires were sent back from 12 NFZ branches. In 2022, CP cases increased by 7%, primarily among adults, while pediatric cases dropped by 21%. Despite a rising trend, the proportion of patients receiving HEN remained relatively low. Among children, it increased from 2.1% in 2012 to 3.3-3.5% in 2019-2021. For adults, it nearly doubled from 0.8% in 2012 to 1.7% in 2022. The prevalence of enteral feeding correlated with patient age, with a noticeable increase among older children and adolescents. CONCLUSIONS National Health Fund data highlight the need for a nationwide registry of patients with CP. A relatively small proportion of pediatric and adult CP patients receive HEN. Increasing clinicians' awareness of HEN availability is necessary to improve the quality of life for more CP patients.
Collapse
Affiliation(s)
- Maciej Zagierski
- Department of Paediatrics, Gastroenterology, Allergology & Paediatric Nutrition, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.Z.)
| | - Angelika Górska
- Nutricia Polska Sp. z o.o., ul. Bobrowiecka 8, 00-728 Warsaw, Poland
| | - Agnieszka Zagierska
- Department of Paediatrics, Gastroenterology, Allergology & Paediatric Nutrition, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.Z.)
| | | | - Michał Seweryn
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Gustawa Herlinga-Grudzinskiego 1, 30-705 Krakow, Poland
| | - Agnieszka Szlagatys-Sidorkiewicz
- Department of Paediatrics, Gastroenterology, Allergology & Paediatric Nutrition, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (M.Z.)
| |
Collapse
|
2
|
Zambelli L, Aumar M, Ley D, Antoine M, Coopman S, Morcel J, Bequet E, Guimber D, Cailliau E, Peretti N, Gottrand F. Home enteral nutrition does not decrease oral feeding in children during the first year of nutritional support. Clin Nutr 2024; 43:781-786. [PMID: 38340410 DOI: 10.1016/j.clnu.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Enteral nutrition is necessary when nutritional status is poor and oral intake is insufficient or impossible. Although it has been suspected to reduce spontaneous oral feeding, no study has formally assessed the influence of enteral nutrition on pediatric oral intake. The present study aimed to evaluate variation in oral feeding intake after enteral nutrition initiation, and to identify factors influencing oral feeding. METHODS This retrospective cohort study included 149 pediatric patients from two French tertiary care hospitals, who received home enteral nutrition from 2009 to 2022. The patients were aged 2 months to 17 years (median age 3 years, interquartile range 1.3-9.2). Oral and enteral intakes were assessed when enteral nutrition was initiated (M0), and again at M3 (n = 123), M6 (n = 129), and M12 (n = 134) follow-ups, based on dieticians' and home services' reports. Oral feeding and body mass index z score variations during follow-ups were evaluated using a linear mixed regression model, including "time" as a fixed effect and "patient" as a random effect. Factors associated with oral feeding changes were assessed using a model interaction term. RESULTS Oral intake did not vary significantly (P = 0.99) over time and accounted for 47.4% ± 27.4%, 46.9% ± 27.4%, 48.4% ± 28.2%, and 46.6% ± 26.9% of the ideal recommended daily allowance (calculated for the ideal weight for height) at M0, M3, M6, and M12, respectively. Delivery method (nasogastric tube versus gastrostomy), prematurity, underlying disease, history of intrauterine growth retardation, and speech therapy intervention did not influence oral intake. Administration (i.e., exclusively continuous nocturnal infusion versus daytime bolus) led to different oral intake development, although oral intake also differed at M0. CONCLUSIONS Enteral nutrition, although increasing total energy intake, does not alter oral feeding during the first year of administration. Only the mode of administration might influence oral intake.
Collapse
Affiliation(s)
- L Zambelli
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France; Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Liège University Hospital, Liège, Belgium.
| | - M Aumar
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - D Ley
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - M Antoine
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - S Coopman
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - J Morcel
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - E Bequet
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Liège University Hospital, Liège, Belgium.
| | - D Guimber
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - E Cailliau
- Biostatistics Department, CHU Lille, F-59000 Lille, France.
| | - N Peretti
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Hospices Civils de Lyon, Lyon, France.
| | - F Gottrand
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| |
Collapse
|