Epidemiology

The overall prevalence and incidence of SBS are difficult to assess accurately in the absence of national registries for SBS, but they can be estimated using parenteral nutrition (PN) registries. Using PN registry data may underestimate the prevalence and incidence of SBS because not all patients with SBS require PN, and approximately 50% to 70% of patients who initially require PN are eventually weaned off it.[3][4] A study in Finland found the prevalence of intestinal failure (including individuals with conditions other than SBS) to be 11.7 per million of the population, which is similar to other western European countries.[5]

In the early 1990s, the Oley Foundation home PN registry for the US estimated that approximately 40,000 patients needed PN annually, with 30% of these requiring PN for SBS or its associated conditions (e.g., radiation enteritis).[6]

In 1997, the European Society for Parenteral and Enteral Nutrition (ESPEN) Working Group carried out a survey to estimate the annual incidence of home PN for 7 European countries. They reported prevalence and annual incidence (per million), respectively, as: Denmark, 12.7 and 2.8; Netherlands, 3.7 and 3.0; UK, 3.7 and 1.2; France, 3.6 and 2.9; Belgium, 3.0 and 2.6; Portugal, 1.1 and 0.36; and Spain, 0.65 and 0.7.[7] In 2012, an Italian study reported a point prevalence of home PN (for gastrointestinal disease) of approximately 11.7 per million.[8] In Europe, Denmark has long been thought to have the highest number of patients receiving long-term home PN as suggested by the ESPEN study, and another Danish study (between 1996 and 2001) that reported a prevalence and annual incidence of home PN of 19.2 and 5.0 per million, respectively.[9] More recent data suggest that home PN is increasing in some European countries, such as the UK and Spain. In 2016, the point prevalence and annual incidence of home PN in the UK were reported to be 21.0 and 5.0 per million, respectively (although these data also included those receiving only intravenous fluids).[10] In 2013, the point prevalence of home PN in Spain was reported to be approximately 4.0 per million.[11]

A number of epidemiological studies have focused on SBS in infants. In one US study of over 12,000 infants, the incidence of surgery-induced SBS was 0.7%.[12]​ A study from Italy found an incidence of 0.1% in over 30,000 live births, and 0.5% among very low-weight premature infants.[13]​​

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