An interim analysis of colorectal cancer cases from a global registry of adults with short bowel syndrome and intestinal failure receiving teduglutide

Background: Parenteral nutrition (PN) is necessary to overcome malnutrition in hospitalized patients with acute or chronic intestinal failure, but is associated with complications.Physicians often lack knowledge in clinical nutrition, which makes clinical decision support tools recommended for prescribing PN.This study evaluated the impact of the OLIVE TREE, a decision tree integrated into the prescribing software at University Hospital Leuven, Belgium, on prescribing behavior and safety.Methods: Two cohorts were compared: patients who received OLIVE TREE-guided PN initiation and those who did not.The primary outcome, assessed in the first cohort, was the proportion of patients for whom the OLIVE TREE impacted prescribing behavior.Secondary outcomes included changes in initial PN regimens, time to regimen change, mortality and PNrelated complications (hyperglycemia, liver dysfunction, fluid overload, catheter-related thrombosis, central line associated bloodstream infection and PN-related intensive care transfer).Results: An impact on prescribing behavior was observed in 33 of 63 patients (52.4%; 95% CI 39.4-65.1;p < 0.001), resulting in providing more calories (27.0%), less calories (9.5%) and more refeeding protocols (6.3%).Initial PN regimens were altered in 54.0% of both cohorts, with a median time to change of six days (p = 0.820).No significant differences were found in mortality (1.6% and 3.2%; p = 0.747) or complications (31.9% and 48.1%; p = 0.284) between the OLIVE TREE and non-OLIVE TREE cohort.Conclusions: The OLIVE TREE significantly impacted prescribing behavior, without leading to earlier or more frequent PN regimen changes or increased complications.