The Influence of Enteral Nutrition on Infectious Complications and Outcomes in Patients with Acute Pancreatitis

Aim: to evaluate the influence of enteral nutrition (EN) on infectious complications and outcomes in patients with acute pancreatitis (AP). Objectives: 1. To determine the incidence of moderately severe and severe AP. 2. To determine the frequency of EN use for patients with moderately severe and severe AP. 3. To evaluate the influence of EN on infectious complication and outcomes in patients with moderately severe and severe AP. 4. To evaluate the influence of early EN on infectious complication and outcomes in patients with moderately severe and severe AP. Methods and participants: A retrospective study on patients with AP hospitalized in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics in 2017. 4 groups of participants: I – treated with EN, II – other methods, III – early EN, IV – delayed EN. Results: There were 158 cases of AP: 44,3% (n=70) of mild, 35,4% (n=56) of moderately severe and 20,3% (n=32) of severe cases. Out of 71 participants 47,9% (n=34) were treated with EN and 52,1% (n=37) – with other nutritional methods. 41,2% (n=14) of the Ist group and 19,4% (n=6) from the IInd group had infectious complications (p=0,020). 70,6% (n=24) of the Ist group recovered and 29,4% (n=10) had lethal outcomes, while 89,2% (n=33) of the IInd group recovered and 10,8% (n=4) were declared dead (p=0,049). Infectious complications occurred in 25% (n=3) of the group treated with early EN and 50% (n=11) – of delayed EN group (p=0,157). In the IIIrd group 91,7% (n=11) recovered and 8,3% (n=1) had lethal outcome, while 59,1% (n=13) in the IVth group recovered and 40,9% (n=9) were declared dead (p=0,046). Conclusions: 1. One third of all AP cases were moderately severe and one fifth - severe. 2. Almost half of all patients with moderately severe and severe AP were treated with enteral nutrition. 3. Statistically more infectious complications and lethal outcomes occurred in the group of patients with moderately severe and severe AP who were treated with enteral nutrition. 4. There was no statistical difference on incidence of infectious complications between early and delayed enteral nutrition groups. Early enteral nutrition group had statistically less lethal outcomes