Abstract：
OBJECTIVE: The New Zealand National Intestinal Failure and Rehabilitation Service (NZ-NIFRS) was established in October 2015 to gather longitudinal data on the aetiology, clinical course and outcomes of children with intestinal failure (IF). One main objective is to achieve health equity for patients with IF in NZ.
METHODS: Clinical outcomes (enteral autonomy, parenteral nutrition (PN) dependence, death or intestinal transplantation) for IF patients diagnosed from October 2015 to 2018 were analysed; comparisons were made by ethnicity and socio-economic status (SES) using published \'prioritised-ethnicity\' health data and the NZ index of deprivation, respectively. The Cox proportional-hazards model was used to assess time to enteral autonomy.
RESULTS: Of the 208 patients (55.77% male, 43.75% preterm), 170 (81.73%) achieved enteral autonomy and 14 (6.73%) remained PN dependent. Pacific and Māori children accounted for 12.98% and 27.88% of the patient cohort, respectively, compared to 9.46% and 25.65% of the NZ paediatric population. More significantly, IF patients with a high NZ socio-economic deprivation score were overrepresented, with 35.92% in the highest deprivation quintile and 10.19% in the least deprived quintile, compared to 23.53% and 20.31%, respectively, of the NZ paediatric population. There were no significant differences in primary clinical outcomes for any patients based on ethnicity or SES.
CONCLUSIONS: While disparities in ethnicity and social deprivation do exist in the incidence of IF in NZ children, clinical outcomes are similar for children regardless of ethnicity or SES. NZ-NIFRS has achieved one of its core objectives: to achieve health equity for all patients with IF nationwide.
METHODS: Clinical outcomes (enteral autonomy, parenteral nutrition (PN) dependence, death or intestinal transplantation) for IF patients diagnosed from October 2015 to 2018 were analysed; comparisons were made by ethnicity and socio-economic status (SES) using published \'prioritised-ethnicity\' health data and the NZ index of deprivation, respectively. The Cox proportional-hazards model was used to assess time to enteral autonomy.
RESULTS: Of the 208 patients (55.77% male, 43.75% preterm), 170 (81.73%) achieved enteral autonomy and 14 (6.73%) remained PN dependent. Pacific and Māori children accounted for 12.98% and 27.88% of the patient cohort, respectively, compared to 9.46% and 25.65% of the NZ paediatric population. More significantly, IF patients with a high NZ socio-economic deprivation score were overrepresented, with 35.92% in the highest deprivation quintile and 10.19% in the least deprived quintile, compared to 23.53% and 20.31%, respectively, of the NZ paediatric population. There were no significant differences in primary clinical outcomes for any patients based on ethnicity or SES.
CONCLUSIONS: While disparities in ethnicity and social deprivation do exist in the incidence of IF in NZ children, clinical outcomes are similar for children regardless of ethnicity or SES. NZ-NIFRS has achieved one of its core objectives: to achieve health equity for all patients with IF nationwide.
摘要：
目的：新西兰国家肠衰竭和康复服务（NZ-NIFRS）于2015年10月成立，以收集有关病因的纵向数据。儿童肠衰竭（IF）的临床过程和结果。一个主要目标是实现新西兰IF患者的健康公平。
方法：临床结果(肠内自主性，肠外营养（PN）依赖性，对2015年10月至2018年诊断的IF患者的死亡或肠道移植）进行了分析；使用公布的“优先种族”健康数据和新西兰剥夺指数，按种族和社会经济地位（SES）进行了比较，分别。Cox比例风险模型用于评估肠内自主时间。
结果：在208例患者中（55.77%为男性，43.75%早产)，170人(81.73%)实现了肠内自主性，14人(6.73%)仍然依赖PN。太平洋和毛利儿童占患者队列的12.98％和27.88％，分别,相比之下，新西兰儿科人群的比例为9.46%和25.65%。更重要的是,如果NZ社会经济剥夺得分高的患者人数过多，最高剥夺五分之一为35.92%，最低剥夺五分之一为10.19%，与23.53%和20.31%相比，分别,新西兰的儿科人口。根据种族或SES，任何患者的主要临床结局均无显著差异。
结论：虽然新西兰儿童IF的发病率存在种族和社会剥夺的差异，无论种族或SES,儿童的临床结局相似.NZ-NIFRS已经实现了其核心目标之一：实现全国所有IF患者的健康公平。
方法：临床结果(肠内自主性，肠外营养（PN）依赖性，对2015年10月至2018年诊断的IF患者的死亡或肠道移植）进行了分析；使用公布的“优先种族”健康数据和新西兰剥夺指数，按种族和社会经济地位（SES）进行了比较，分别。Cox比例风险模型用于评估肠内自主时间。
结果：在208例患者中（55.77%为男性，43.75%早产)，170人(81.73%)实现了肠内自主性，14人(6.73%)仍然依赖PN。太平洋和毛利儿童占患者队列的12.98％和27.88％，分别,相比之下，新西兰儿科人群的比例为9.46%和25.65%。更重要的是,如果NZ社会经济剥夺得分高的患者人数过多，最高剥夺五分之一为35.92%，最低剥夺五分之一为10.19%，与23.53%和20.31%相比，分别,新西兰的儿科人口。根据种族或SES，任何患者的主要临床结局均无显著差异。
结论：虽然新西兰儿童IF的发病率存在种族和社会剥夺的差异，无论种族或SES,儿童的临床结局相似.NZ-NIFRS已经实现了其核心目标之一：实现全国所有IF患者的健康公平。
