Nutritional support is a critical component in the early management of acute pancreatitis (AP), preventing malnutrition and reducing serious complications and mortality. A recent meta-analysis suggests that Immediate or early Oral Refeeding could reduce the length of stay (LOS) and costs without increasing adverse events in mild to moderate AP. The study findings were published in the journal Pancreatology on December 01, 2021.
The timing of oral refeeding can affect LOS and the recovery of AP. However, the optimal timing for oral refeeding is still controversial for AP. Therefore, researchers of The First Affiliated Hospital of Nanchang University, China, conducted a meta-analysis to investigate the effects of immediate or early versus delayed oral feeding on mild and moderate AP, regardless of improvement in clinical signs or laboratory indicators.
In a systematic review and meta-analysis of randomized controlled trials (RCTs) based on data from Embase, Cochrane Library, PubMed, Web of science, and CBM, the researchers included 8 RCTs including 748 patients with mild to moderate AP. They performed a random effect model for meta-analysis to calculate the risk ratio (RR) and standardized mean difference (SMD).
Key findings of the study:
♦ Upon analysis, the researchers noted that the patients in IOR (Immediate or early Oral Refeeding) group had fewer costs [SMD -0.83] and shorter LOS [SMD -1.01] than the DOR (Delayed Oral Refeeding) group patients.
♦ However, they found no difference in
Mortality [RR 0.54],
Pain relapse rate [RR 0.58],
Feeding intolerance rate [RR 0.61],
AP progression rate [RR 0.21] and
Overall complications rate [RR 0.41] between the IOR and DOR groups.
The authors concluded, "IOR could reduce LOS and costs without increasing adverse events in patients with MAP. However, in the context of its limitations, further deeper and wider study are necessary."
For further information:
DOI: https://doi.org/10.1016/j.pan.2021.11.009