Review
Copyright ©The Author(s) 2023.
World J Clin Cases. Apr 26, 2023; 11(12): 2582-2603
Published online Apr 26, 2023. doi: 10.12998/wjcc.v11.i12.2582
Table 4 Meta-analysis on early enteral nutrition vs delayed enteral nutrition/total parenteral nutrition in acute pancreatitis
Ref.
Inclusion
Conclusion
Li et al[35], 20136 studiesEarly EN vs delayed EN: reduced incidence of all infections (OR: 0.38; 95%CI: 0.21–0.68, P < 0.05); reduced incidence of catheter-related sepsis (OR: 0.26; 95%CI: 0.11–0.58, P < 0.05); reduced pancreatic infection (OR: 0.49; 95%CI: 0.31–0.78, P < 0.05); reduced risk of hyperglycemia (OR: 0.24; 95%CI: 0.11–0.52, P < 0.05); reduced length of hospitalization (mean difference: -2.18; 95%CI: -3.48-(-0.87); P < 0.05); reduced mortality (OR: 0.31; 95%CI: 0.14–0.71, P < 0.05); and no difference in pulmonary complications (P > 0.05)
Feng et al[36], 20174 RCTs, 2 retrospective studiesEarly EN (within 48 h) vs delayed EN (after 48 h): reduced risk of multiple organ failure (RR: 0.67; 95%CI: 0.46-0.99; P = 0.04); decreased systemic inflammatory response syndrome but not significant (RR: 0.85; 95%CI: 0.71-1.02; P = 0.09); and no significant difference in mortality (RR: 0.78; 95%CI: 0.27-2.24; P = 0.64)
Qi et al[37], 20188 studies (727 patients)Early EN vs late EN and TPN: risk of mortality (OR: 0.56; 95%CI: 0.23-1.34); multiple OF (OR: 0.40; 95%CI: 0.20-0.79); infectious complications: (OR: 0.57; 95%CI: 0.23-1.42); adverse events (OR: 0.45; 95%CI: 0.17-1.21); and pancreatitis-related infections (OR: 0.83; 95%CI: 0.59-1.18)
Zeng et al[38], 201917 RCTsEarly EN vs delayed EN: lower mortality (9.21% vs 11.22%) but no statistical significance between the two groups (RR: 0.86; 95%CI: 0.60-1.23; P = 0.42); reduced risk of complications (RR: 0.81; 95%CI: 0.70-0.93; P = 0.002); reduced incidence of infections (RR: 0.68; 95%CI: 0.51-0.91, P = 0.009); and no difference in risk of multi OF (RR: 0.82; 95%CI: 0.59-1.14; P = 0.23)
CI: Confidence interval; EN: Enteral nutrition; OF: Organ failure; OR: Odds ratio; RCT: Randomized controlled trial; RR: Relative risk; TPN: Total parenteral nutrition.