Prognostic Factors Influencing Surgical Outcomes in Adult Patients with Crohn’s Disease: A Retrospective Cohort Study

Background: Contamination of parenteral nutrition (PN) led to the removal of chromium (January 2019) and the prescription of aluminum-free calcium gluconate (since March 2014) for patients with high aluminum concentrations in our center.The aim of this study was to assess plasma chromium and aluminum concentrations before and after these changes in patients with intestinal failure (IF).Methods: IF patients <18 years receiving home PN between January 2018 and May 2023 were included.Plasma chromium (reference value <9.6 nmol/L) and aluminum measurements (reference value <293 nmol/L) were retrospectively collected and compared before and after PN changes using the Wilcoxon signed-rank test.Results: Plasma concentrations were available for chromium and aluminum in 68 and 70 patients, respectively (Table 1).Median chromium concentration before removal from PN was 39.6 nmol/L versus 25.1 after (n=38, p<0.001, median time between measurements 9.7 months), however all levels remained above normal.Twenty-four patients (34%) received aluminumfree PN: median aluminum concentration was 550 nmol/L before the switch to aluminum-free PN and 274 nmol/L after (p= 0.002, median time between measurements 11 months).Conclusions: Removal of chromium and use of aluminum-free PN seems successful in reducing plasma concentrations.However, persistence of abnormal values suggests that further optimization of PN is needed.