Retrospective Study On The Effect Of More Early Enteral Nutrition On Prognosis Of Patients With Severe Acute Pancreatitis

Background:Early enteral nutrition through a nasoenteric feeding tube is often used in patients with severe acute pancreatitis to prevent gut-derived infections.I made a retrospective study to investigate the effect of more early enteral nutrition(starts within 48 hours)on the prognosis of severe acute pancreatitis(SAP).Methods:I enrolled 48 patients with severe acute pancreatitis from January 1,2013 to September 30,2016 in Sir Run Run Shaw Hospital,who met diagnostic criteria in Classification Of Acute Pancreatitis—2012:Revision Of the Atlanta Classification And Definitions By International Consensus.These patients were assigned to more early group if they started enteral nutrition within 48 hours after admission,the others were assigned to early group.By comparing two groups' hospitalization time,28 day mortality,complications within the 6 months(organ failure,pseudocyst,pulmonary infection,gastrointestinal fistula,peripancreatic vascular complications),and mortality in the first 6 months,I could investigate the effect of more early enteral nutrition(starts within 48 hours)on the prognosis of severe acute pancreatitis.Results:A total of 48 patients were enrolled.There are 17 patients in the more early group and 31 patients in the early group.There were no significant differences between the more early group and the early group in age(49.53±14.69 and 53.94±9.68,respectively;P=0.217),APACHE II score(14.4±6.26and14.26±5.18,respectively;P=0.900).There were no significant differences between more early group and the early group in the hospitalizati on time(24.12±14.38 and 27.71±25.34,respectively;P=0.594),28 day mortality(12%and 3%respectively;P=0.242),mortality in the first 6 months(18%and 6%respectively;P=0.225)and each of complications listed(all P>0.05).There were no significant differences between the more early group and the early group in inflammatory markers and nutritional parameters(all P>0.05).Conclusions:This trial did not show the superiority of more early enteral nutrition started in 48 hours,as compared with the enteral nutrition after 48 hours,in reducing the rate of complications or death in patients with severe acute pancreatitis.