OBJECTIVES: Short bowel syndrome with intestinal failure (SBS-IF) is a rare, chronic, debilitating malabsorptive condition often caused by massive resection of the small intestine, leading to lifetime dependence on parenteral support (PS). Objectives of this study were to quantify patients' healthcare resource utilization (HCRU), frequency of disease-related symptoms, comorbidities, and PS-specific complications.

METHODS: A retrospective, real-world analysis of insurance claims between January 2019 – March 2023 was conducted employing the Komodo Healthcare Map™ data. Patients were indexed at first observed PS insurance claim and classified SBS-IF if they had: (1) chronic and continuous PS claims for ≥6 months, (2) intestinal resection or congenital abnormality history, and (3) concurrent diagnosis of intestinal malabsorption. Quantitative analyses estimated symptom and comorbidity frequency, PS-specific complications, and HCRU.

RESULTS: Overall, 1,587 SBS-IF patients dependent on PS were included in the analysis. Mean age was 35 years at index and 65% were females, with a median follow-up of 2.8 years. Most common comorbidities included depression/anxiety (54%), hypertension (43%), kidney stones (14%), and deep venous thrombosis (DVT) (7%). Most common symptoms included abdominal pain (67%), esophageal disorder (62%), and fever (57%). Approximately 31% of patients had claims for catheter-related bloodstream infections (CRBIs), while 7% of patients had a DVT claim. Patients with ≥1 nutrition claim/week had twice the frequency of CRBIs than patients with ≤0.5 claims/week (39% vs. 19%). Patients frequently required care from high-intensity healthcare settings; 85% of patients visited the emergency department (ED) (mean 4.5 visits) and 75% were admitted as inpatients (mean 2.6 admissions). The most common diagnosis leading to inpatient care was CRBIs (36%).

CONCLUSIONS: Patients with SBS-IF requiring chronic PS demonstrated high rates of ED and inpatient encounters, oftentimes from PS-related complications. Future treatments should aim to minimize frequency of PS administration, which is associated with elevated risk of CRBIs and greater HCRU.