Peer-reviewed article
Health-related quality of life in pediatric patients with intestinal failure without neurodevelopmental delay: a systematic review and meta-analysis.
Francesco Milo, Deny Menghini, Teresa Capriati, Lorenzo Norsa, Francesco Proli et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review and meta-analysis examined health-related quality of life in children under 18 with intestinal failure, a condition that prevents nutrient absorption. The review pooled data from 12 studies involving 510 children with an average age of 7 years. Children with intestinal failure reported significantly lower overall quality of life compared to healthy children, particularly in physical domains, though emotional and social impacts were less severe. The authors conclude that children with this condition need targeted interventions addressing both physical and psychological needs.
Key points
- Pediatric patients with intestinal failure had lower overall quality of life compared to healthy children (SMD = -0.62 in child-report and -0.70 in parent-report)
- Physical domains were more affected than emotional and social domains
- Parents tended to overestimate their children's emotional and social quality of life compared to children's own reports
- The review included 14 eligible studies with data from 12 studies, all rated as fair to good quality
- The pooled sample included 510 pediatric participants with mean age of 7.0 years
Limitations
The review does not specify which countries the included studies were conducted in, limiting understanding of geographic variation. The review focuses only on children without neurodevelopmental delay, so findings do not apply to the broader population of children with intestinal failure who may have co-occurring developmental conditions.
Abstract
BACKGROUND: Intestinal failure (IF) is a broad term encompassing various conditions that hinder the body's ability to absorb nutrients for growth and maintenance. These conditions can significantly affect child's well-being, leading to physical limitations, psychological distress, and social isolation. We aimed to evaluate the available data on health-related quality of life (HRQoL) in pediatric patients with IF and without neurodevelopmental delay. METHODS: For this systematic review and meta-analysis, we searched CINAHL, EMBASE, PsycINFO, PubMed, and Web of Science. All observational studies of pediatric patients (< 18 years) with IF which measured HRQOL and with evidence of absence of neurodevelopmental delay were included, without language or date restrictions, up to June 2024. We did separate random-effects meta-analyses for overall HRQOL and subgroup domains. Evidence from observational studies was synthesised as differences between standardised mean differences (SMDs) for all subgroup domains. Heterogeneity was assessed using the I² statistic and the Cochran Q test. The quality of the evidence was assessed with the Newcastle-Ottawa scale. This study is registered on PROSPERO, number CRD42024561812. RESULTS: Of 491 records identified, 14 were eligible and data were available for 12 studies, all of which had a fair/good quality. The included studies involved a pooled sample of 510 participants (mean age = 7.0 ± 3.6 years). The analysis disclosed that compared to healthy children, pediatric patients with IF had lower overall quality of life in both child- and parent-report (Standardized Mean Difference [SMD]= -0.62; 95% CI [-0.80, -0.43]; p < 0.001, and SMD= -0.70; 95% CI [-1.11, -0.28]; p < 0.001, respectively), except for emotional and social domains (SMD[child] = -0.23; 95% CI [ -0.38, -0.08]; p = 0.001 Vs SMD[parent]= -0.23; 95% CI [ -0.60, 0.14]; p = 0.21, and SMD[child] = -0.40; 95% CI [ -0.70, -0.10]; p = 0.007 Vs SMD[parent]= -0.24; 95% CI [ -0.62, 0.14]; p = 0.21, respectively), where parents overestimate emotional and social HRQOL of their children. CONCLUSIONS: This study highlights the significant impact of IF on well-being of pediatric patients. Targeted interventions addressing both physical and psychosocial needs are crucial to improve HRQOL in this population.