Karolina Wyszomirska

Objectives: This study aimed to determine the prevalence of gastrostomy-related procedures and paediatric patients undergoing these procedures, alongside temporal trends, patient profiles, and regional disparities in procedure provision. Methods: We analysed anonymised National Health Fund data pertaining to patients who underwent procedures at regional centres in Poland from 2010 to 2019. To assess temporal patterns, procedure counts and patient prevalence were aggregated annually, and trends over time were evaluated using the Mann–Kendall trend test. Results: Percutaneous Endoscopic Gastrostomy (PEG) was performed in 2638 patients, while gastrostomy-other was performed in 2087 patients. The cumulative prevalence of patients during the 10-year follow-up period was as follows: PEG: 37.7 per 100,000 children; gastrostomy—other: 29.9 per 100,000 children. The procedure prevalence rates were PEG: 40.1 per 100,000 children; gastrostomy-other: 43.0 per 100,000 children. Gastrostomy-related procedures were performed most frequently in the first three years of life. Conclusions: Patient sex, age, and centre location influenced utilization, as shown by local variations. The increasing trend in gastrostomy procedures and the young patient age indicate the growing use of gastrostomy, with endoscopic placement being the most common. Given the rising numbers requiring gastrostomy, optimizing inter-centre collaboration could contribute to the identification and treatment of patients with special nutritional needs.

Background: Home artificial nutrition (HAN) is a developing method of treatment that reduces the need for hospitalizations. The epidemiology of pediatric HAN in Poland has not yet been covered in detail. This study is a longitudinal nationwide analysis of incidence, prevalence, and patients’ profile for HAN in Polish children. Methods: Assessment of National Health Fund (NFZ) data covering all pediatric patients treated with HAN in Poland between 2010 and 2018. Results: HAN was received by 4426 children, 65 patients were on home enteral nutrition (HEN) or home parenteral nutrition (HPN) at different times (HEN n = 3865, HPN n = 626). HAN was most frequently started before the child was 3 years old and long-term HAN programs (5–9 years) were reported. The most common principal diagnosis in HEN was food-related symptoms and signs. In HPN, it was postoperative gastrointestinal disorders. A regionally differentiated prevalence of HAN patients and centers was demonstrated. Mortality among patients was 24.9% for HEN, and 9.6% for HPN, and the main in-hospital cause of death was cardiac arrest. Conclusions: HAN’s use is increasing and evolving in Poland. Uneven distribution of patients and centers results in difficult access to the nutritional procedure which, together with the increasing number of patients, highlights the need for data analysis and development of nutrition centers.