RESUMEN
OBJECTIVES: Oral feeding intolerance (OFI) is a common complication of acute pancreatitis that leads to prolonged hospitalization, increased use of hospital resources, and impaired quality of life. However, there are no clinically useful predictors of OFI. The aims of this study were to determine whether gastrointestinal dysmotility is associated with the development of OFI, and whether the gastroparesis cardinal symptom index (GCSI) can be used as a predictive tool in a clinical setting. METHODS: This was a prospective cohort study. The primary outcome was the development of OFI. Daily GCSI total score and subscores (nausea/vomiting, early satiety, and bloating) were recorded. Univariate and multivariate binary logistic regression analyses were conducted, adjusting for age, etiology of pancreatitis, severity, diabetes status, and time from symptom onset to hospital admission. RESULTS: The study included 217 consecutive adult patients with acute pancreatitis. Multivariate analyses showed significant associations between OFI occurrence and the total GCSI score on day 2 of hospital admission (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.02-2.00), the highest total GCSI score (OR, 1.38; 95% CI, 1.03-1.86), the day 2 nausea/vomiting subscore (OR, 1.40; 95% CI, 1.04-1.89), the day 2 bloating subscore (OR, 1.25; 95% CI, 1.01-1.54), and the highest bloating subscore (OR, 1.32; 95% CI, 1.08-1.63). CONCLUSIONS: Gastrointestinal dysmotility is associated with the development of OFI and the GCSI has potential as a clinically useful predictive tool in the setting of acute pancreatitis. The developed nomogram holds promise but needs to be validated externally.
Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Nomogramas , Pancreatitis/complicaciones , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Determinación de Punto Final , Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Femenino , Gastroparesia/etiología , Gastroparesia/terapia , Hospitalización , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Náusea/etiología , Náusea/terapia , Pancreatitis/terapia , Estudios Prospectivos , Calidad de Vida , Factores de Riesgo , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Vómitos/etiología , Vómitos/terapia , Adulto JovenRESUMEN
With the increasing prevalence of metabolic comorbidities, their impact on outcomes of patients with acute pancreatitis needs to be considered. Metabolic comorbidities, such as diabetes mellitus, obesity, and metabolic syndrome, have been shown to have a role to play in the course of disease. This scoping review aims to map published clinical studies that have investigated the impact of metabolic comorbidities on outcomes in patients with acute pancreatitis.