Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort study

Background Inability to advance to an oral diet, or oral feeding intolerance, is a common complication in patients with acute pancreatitis associated with worse clinical outcomes. The factors related to oral feeding intolerance are not well studied. Objective We aimed to determine the incidence and...

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Autores: Pothoulakis, I, Nawaz, H, Paragomi, P, Jeong, K, Talukdar, R, Kochhar, R, Goenka, MK, Gulla, A, Singh, VK, Gonzalez, JA, Ferreira, M, Barbu, ST, Stevens, T, Gutierrez, SC, Zarnescu, NO, Capurso, G, Easler, J, Triantafyllou, K, Pelaez-Luna, M, Thakkar, S, Ocampo, C, De-Madaria, E, Wu, BU, Cote, GA, Abebe, K, Tang, G, Lahooti, A, Phillips, AE, Papachristou, GI
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Recursos:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p6623
Acesso em linha:https://isabial.portalinvestigacion.com/publicaciones6623
Access Level:acceso abierto
Palavra-chave:Enteral feeding
intolerance
oral feeding
acute pancreatitis
prognosis
severity
predictors
APPRENTICE
diet
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spelling Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort studyPothoulakis, INawaz, HParagomi, PJeong, KTalukdar, RKochhar, RGoenka, MKGulla, ASingh, VKGonzalez, JAFerreira, MBarbu, STStevens, TGutierrez, SCZarnescu, NOCapurso, GEasler, JTriantafyllou, KPelaez-Luna, MThakkar, SOcampo, CDe-Madaria, EWu, BUCote, GAAbebe, KTang, GLahooti, APhillips, AEPapachristou, GIEnteral feedingintoleranceoral feedingacute pancreatitisprognosisseveritypredictorsAPPRENTICEdietBackground Inability to advance to an oral diet, or oral feeding intolerance, is a common complication in patients with acute pancreatitis associated with worse clinical outcomes. The factors related to oral feeding intolerance are not well studied. Objective We aimed to determine the incidence and risk factors of oral feeding intolerance in acute pancreatitis. Methods Patients were prospectively enrolled in the Acute Pancreatitis Patient Registry to Examine Novel Therapies in Clinical Experience (APPRENTICE), an international acute pancreatitis registry, between 2015 and 2018. Oral feeding intolerance was defined as worsening abdominal pain and/or vomiting after resumption of oral diet. The timing of the initial feeding attempt was stratified based on the day of hospitalization. Multivariable logistic regression was performed to assess for independent risk factors/predictors of oral feeding intolerance. Results Of 1233 acute pancreatitis patients included in the study, 160 (13%) experienced oral feeding intolerance. The incidence of oral feeding intolerance was similar irrespective of the timing of the initial feeding attempt relative to hospital admission day (P = 0.41). Patients with oral feeding intolerance were more likely to be younger (45 vs. 50 years of age), men (61% vs. 49%) and active alcohol users (44% vs. 36%). They also had higher blood urea nitrogen (20 vs. 15 mg/dL;P<0.001) and hematocrit levels (41.7% vs. 40.5%;P = 0.017) on admission; were more likely to have a non-biliary acute pancreatitis etiology (69% vs. 51%), systemic inflammatory response syndrome of 2 or greater on admission (49% vs. 35%) and at 48 hours (50% vs. 26%;), develop pancreatic necrosis (29% vs. 13%), moderate to severe acute pancreatitis (41% vs. 24%) and have a longer hospital stay (10 vs. 6 days; allP<0.04). The adjusted analysis showed that systemic inflammatory response syndrome of 2 or greater at 48 hours (odds ratio 3.10; 95% confidence interval 1.83-5.25) and a non-biliary acute pancreatitis etiology (odds ratio 1.65; 95% confidence interval 1.01-2.69) were independent risk factors for oral feeding intolerance. Conclusion Oral feeding intolerance occurs in 13% of acute pancreatitis patients and is independently associated with systemic inflammatory response syndrome at 48 hours and a non-biliary etiology.JOHN WILEY & SONS LTD2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones6623United European Gastroenterology JournalISSN: 20506406ISSNe: 20506414reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p66232026-06-12T10:20:37Z
dc.title.none.fl_str_mv Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort study
title Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort study
spellingShingle Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort study
Pothoulakis, I
Enteral feeding
intolerance
oral feeding
acute pancreatitis
prognosis
severity
predictors
APPRENTICE
diet
title_short Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort study
title_full Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort study
title_fullStr Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort study
title_full_unstemmed Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort study
title_sort Incidence and risk factors of oral feeding intolerance in acute pancreatitis: results from an international, multicenter, prospective cohort study
dc.creator.none.fl_str_mv Pothoulakis, I
Nawaz, H
Paragomi, P
Jeong, K
Talukdar, R
Kochhar, R
Goenka, MK
Gulla, A
Singh, VK
Gonzalez, JA
Ferreira, M
Barbu, ST
Stevens, T
Gutierrez, SC
Zarnescu, NO
Capurso, G
Easler, J
Triantafyllou, K
Pelaez-Luna, M
Thakkar, S
Ocampo, C
De-Madaria, E
Wu, BU
Cote, GA
Abebe, K
Tang, G
Lahooti, A
Phillips, AE
Papachristou, GI
author Pothoulakis, I
author_facet Pothoulakis, I
Nawaz, H
Paragomi, P
Jeong, K
Talukdar, R
Kochhar, R
Goenka, MK
Gulla, A
Singh, VK
Gonzalez, JA
Ferreira, M
Barbu, ST
Stevens, T
Gutierrez, SC
Zarnescu, NO
Capurso, G
Easler, J
Triantafyllou, K
Pelaez-Luna, M
Thakkar, S
Ocampo, C
De-Madaria, E
Wu, BU
Cote, GA
Abebe, K
Tang, G
Lahooti, A
Phillips, AE
Papachristou, GI
author_role author
author2 Nawaz, H
Paragomi, P
Jeong, K
Talukdar, R
Kochhar, R
Goenka, MK
Gulla, A
Singh, VK
Gonzalez, JA
Ferreira, M
Barbu, ST
Stevens, T
Gutierrez, SC
Zarnescu, NO
Capurso, G
Easler, J
Triantafyllou, K
Pelaez-Luna, M
Thakkar, S
Ocampo, C
De-Madaria, E
Wu, BU
Cote, GA
Abebe, K
Tang, G
Lahooti, A
Phillips, AE
Papachristou, GI
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Enteral feeding
intolerance
oral feeding
acute pancreatitis
prognosis
severity
predictors
APPRENTICE
diet
topic Enteral feeding
intolerance
oral feeding
acute pancreatitis
prognosis
severity
predictors
APPRENTICE
diet
description Background Inability to advance to an oral diet, or oral feeding intolerance, is a common complication in patients with acute pancreatitis associated with worse clinical outcomes. The factors related to oral feeding intolerance are not well studied. Objective We aimed to determine the incidence and risk factors of oral feeding intolerance in acute pancreatitis. Methods Patients were prospectively enrolled in the Acute Pancreatitis Patient Registry to Examine Novel Therapies in Clinical Experience (APPRENTICE), an international acute pancreatitis registry, between 2015 and 2018. Oral feeding intolerance was defined as worsening abdominal pain and/or vomiting after resumption of oral diet. The timing of the initial feeding attempt was stratified based on the day of hospitalization. Multivariable logistic regression was performed to assess for independent risk factors/predictors of oral feeding intolerance. Results Of 1233 acute pancreatitis patients included in the study, 160 (13%) experienced oral feeding intolerance. The incidence of oral feeding intolerance was similar irrespective of the timing of the initial feeding attempt relative to hospital admission day (P = 0.41). Patients with oral feeding intolerance were more likely to be younger (45 vs. 50 years of age), men (61% vs. 49%) and active alcohol users (44% vs. 36%). They also had higher blood urea nitrogen (20 vs. 15 mg/dL;P<0.001) and hematocrit levels (41.7% vs. 40.5%;P = 0.017) on admission; were more likely to have a non-biliary acute pancreatitis etiology (69% vs. 51%), systemic inflammatory response syndrome of 2 or greater on admission (49% vs. 35%) and at 48 hours (50% vs. 26%;), develop pancreatic necrosis (29% vs. 13%), moderate to severe acute pancreatitis (41% vs. 24%) and have a longer hospital stay (10 vs. 6 days; allP<0.04). The adjusted analysis showed that systemic inflammatory response syndrome of 2 or greater at 48 hours (odds ratio 3.10; 95% confidence interval 1.83-5.25) and a non-biliary acute pancreatitis etiology (odds ratio 1.65; 95% confidence interval 1.01-2.69) were independent risk factors for oral feeding intolerance. Conclusion Oral feeding intolerance occurs in 13% of acute pancreatitis patients and is independently associated with systemic inflammatory response syndrome at 48 hours and a non-biliary etiology.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones6623
url https://isabial.portalinvestigacion.com/publicaciones6623
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv JOHN WILEY & SONS LTD
publisher.none.fl_str_mv JOHN WILEY & SONS LTD
dc.source.none.fl_str_mv United European Gastroenterology Journal
ISSN: 20506406
ISSNe: 20506414
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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