{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:42:19Z","timestamp":1761007339142,"version":"build-2065373602"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,3]],"date-time":"2018-12-03T00:00:00Z","timestamp":1543795200000},"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":["Nut in Clin Prac"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To support families managing the complex requirements of home parenteral nutrition (HPN) in pediatric patients, health professionals need information about HPN indications and complications. Nationally representative information is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort analysis of the Truven Health MarketScan Commercial Claims and Encounters Database was performed and identified 683 patients aged \u226418 years receiving HPN during dates of service from January 2013 through September 2015. Baseline diagnoses were measured in the 30 days before the first observed HPN claim (preindex). Indications for older (aged 13\u201318 years) and younger (aged \u226412 years) children were compared. Hospital and emergency department (ED) utilization rates were measured for 30 postindex days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Gastrointestinal diagnoses and\/or symptoms affected more than three\u2010quarters of patients. Short bowel syndrome was more common in younger than in older patients (24% vs 7%, respectively), and colitis was less common (13% vs 33%; both <jats:italic>P<\/jats:italic> &lt; .01). Cancer was common in both age groups (22%\u201323%). Additional diagnoses indicating complex medical conditions were observed in a minority of patients: sepsis (9%), convulsions\/epilepsy (7%), encephalopathy (3%), and immune deficiency (3%). From the preindex to postindex periods, rates of inpatient hospitalization declined from 78% to 41%, but hospital ED visits increased from 10% to 14%. In both periods, &gt;95% of hospital and ED use was disease related.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a nationally representative sample of commercially insured pediatric patients treated with HPN, complex medical conditions were common. Findings highlight the importance of American Society for Parenteral and Enteral Nutrition recommendations for team\u2010based care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ncp.10225","type":"journal-article","created":{"date-parts":[[2018,12,4]],"date-time":"2018-12-04T02:38:03Z","timestamp":1543891083000},"page":"242-249","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pediatric Home Parenteral Nutrition: Indications and Short\u2010Term Outcomes in a Large National Sample of Commercially Insured Children and Adolescents"],"prefix":"10.1002","volume":"34","author":[{"given":"Titilola M.","family":"Afolabi","sequence":"first","affiliation":[{"name":"College of Pharmacy\u2010Glendale Midwestern University  Glendale Arizona USA"},{"name":"Phoenix Children's Hospital  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen A.","family":"Fairman","sequence":"additional","affiliation":[{"name":"College of Pharmacy\u2010Glendale Midwestern University  Glendale Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,12,3]]},"reference":[{"issue":"2","key":"e_1_2_7_2_1","first-page":"S70","article-title":"Guidelines on paediatric parenteral nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), supported by the European Society of Paediatric Research (ESPR). 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