HOME ARTIFICIAL NUTRITIONAL SUPPORT IN CAMBRIDGE HEALTH DISTRICT - 1988-1990

A 2-year prospective study was undertaken to assess the indications for, prevalence and outcome of home artificial nutritional support [HANS] in the Cambridge Health District [CHD], England. Thirty-nine patients were identified, 33 receiving home enteral-tube feeding [HETF] and six receiving home total-parenteral nutrition [HTPN]. About half the patients received HETF to treat chronic anorexia and the remaining half received it because of swallowing difficulties. All HTPN patients had intestinal failure. Patients receiving HTPN were young to middle aged adults, whereas the majority [80%] of those receiving HETF were either children [<16 years] of elderly patients [>60 years]. Patients in both the HETF and HTPN groups tended to be either short-term or long-term feeders. There was a high disease-related mortality rate among the HETF patients [45.5% over 2 years] but there were no deaths in the HTPN group. It is concluded that HANS is provided for a small number of severely disabled individuals, many of whom have a poor prognosis.