{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:30:27Z","timestamp":1760920227401,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T00:00:00Z","timestamp":1599696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite advances in the medical management of inflammatory bowel disease (IBD), a subset of patients may require extensive surgery, leading to short\u2010bowel syndrome\/intestinal failure requiring long\u2010term home parenteral nutrition (PN) or customized intravenous fluid (IVF) support. Our aim was to further define the characteristics of IBD patients requiring home PN\/IVF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is an observational study from a prospective IBD research registry. Patients receiving long\u2010term home PN\/IVF support during 2009\u20132015 were identified and compared with remaining IBD patients. Demographics, surgical history, smoking, narcotic use, IBD treatment, healthcare charges, and presence of biomarkers were reviewed. The IBD\u2010PN group was stratified into 3 groups based on median healthcare charges.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2359 IBD patients, there were 25 (1%, 24 with Crohn's disease) who required home PN\/IVF, and 250 randomly selected IBD patients matched for disease type formed the control population. Median duration of PN use was 27 months (interquartile range, 11\u201366). PN use was significantly associated with smoking, narcotic use, IBD\u2010related operations, and lower quality\u2010of\u2010life scores. Among IBD\u2010PN patients, 7 of 25 (28%, 3 after use of teduglutide) were able to successfully discontinue this modality. Median healthcare charges in the IBD\u2010PN group were $51,456 annually. Median charges in the controls were $3427. Period prevalence mortality was 11.5% in IBD\u2010PN and 3.8% in controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>IBD patients requiring long\u2010term home PN\/IVF support are a small minority in the present era of immunomodulator\/biologic therapy. These refractory patients have a 15\u2010fold increase in annual median healthcare charges compared with control IBD patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.1988","type":"journal-article","created":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T00:04:27Z","timestamp":1597017867000},"page":"1100-1107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical Characteristics of Inflammatory Bowel Disease Patients Requiring Long\u2010Term Parenteral Support in the Present Era of Highly Effective Biologic Therapy"],"prefix":"10.1002","volume":"45","author":[{"given":"Michael","family":"Kurin","sequence":"first","affiliation":[{"name":"Digestive Health Institute University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyce","family":"Anderson","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of 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