ABSTRACT
Factors Influencing Survival on HPEN.................................................................335 Primary Diagnosis .....................................................................................335 Age.............................................................................................................335 Length and Type of Remaining Bowel .....................................................340 Experience of the Supervising Physician..................................................341 Factors That Influence Complications but Not Yet Demonstrated to Influence Survival..................................................................................342
Factors Influencing Quality of Life on HPEN......................................................342 Measurement of Quality of Life (QoL) ....................................................342 QoL for HPN Patients with Nonmalignant Chronic Intestinal Failure ........................................................................................343 QoL for HPN patients with Nonmalignant Chronic Intestinal Failure Compared to Other Patients with Chronic Illness ...........................................................................................344 QoL for HPN Patients with Cancer ..........................................................345 QoL for HEN Patients with Cancer ..........................................................346 QoL for HEN Patients with Neuromuscular Disorders of Swallowing ............................................................................................346 QoL for HEN Patients with Small Bowel Malabsorption........................347 QoL for HEN Patients with Other Disorders ...........................................347
Outstanding Issues in Regard to HPEN Survival and QoL..................................348 References..............................................................................................................349
In the past 30 years, long-term home parenteral and enteral nutrition (HPEN) have become widely available therapies in medically advanced countries for persons with severe intestinal dysfunction. The dysfunction can result from a critical loss of absorbing surface or an inability to convey food to and through the intestinal tract. Figure 21.1 shows the type of diseases where these therapies are typically used.1
