Document Detail


Development of hypertriglyceridemia in patients with enterocutaneous fistulas.
MedLine Citation:
PMID:  19327876     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Hypertriglyceridemia is commonly observed in patients with enterocutaneous fistulas, compromising their health status. In this study potential causes for hypertriglyceridemia in patients with an enterocutaneous fistula are explored and treatment options discussed accordingly. METHODS: A database was created consisting of all consecutively treated patients with an enterocutaneous fistula from 1991 until 2007. Two successive measures of serum triglyceride concentrations of more than 3.0 mmol/L (266 mg/dL) were regarded as hypertriglyceridemia. The relation between fistula specific characteristics and hypertriglyceridemia was analyzed using a multivariable Cox proportional hazard model with time-dependent covariates. RESULTS: A total 102 patients were eligible for this study of whom 25 had hypertriglyceridemia. Multivariable analysis showed that sepsis (HR 4.503, CI 1.778-11.401, P=0.002), high output small bowel fistula (HR 3.534, CI 1.260-9.916, P=0.016), parenteral nutrition (HR 5.689, CI 1.234-26.216, P=0.026) and inflammatory diseases (inflammatory bowel disease vs. malignancy HR 6.211, CI 1.081-35.696, P=0.041) were independent predictors of hypertriglyceridemia. CONCLUSIONS: High triglyceride concentrations in patients with an enterocutaneous fistula were mainly associated with sepsis, a high output small bowel fistula, nutrition by the parenteral route and primary diseases with inflammatory aetiology. This should direct a treatment strategy that focuses on these aspects.
Authors:
Ruben G J Visschers; Steven W M Olde Damink; Malou Schreurs; Bjorn Winkens; Peter B Soeters; Wim G van Gemert
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Publication Detail:
Type:  Journal Article     Date:  2009-03-26
Journal Detail:
Title:  Clinical nutrition (Edinburgh, Scotland)     Volume:  28     ISSN:  1532-1983     ISO Abbreviation:  Clin Nutr     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-08     Completed Date:  2009-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309603     Medline TA:  Clin Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  313-7     Citation Subset:  IM    
Affiliation:
Intestinal Failure Institute Maastricht (IFIM), Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Hypertriglyceridemia / blood,  epidemiology,  etiology*
Inflammation / blood,  complications*
Intestinal Fistula / blood,  complications*,  mortality
Intestine, Small / pathology
Male
Middle Aged
Multivariate Analysis
Parenteral Nutrition / adverse effects*
Proportional Hazards Models
Sepsis / blood,  complications*
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Triglycerides

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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