Evidence map›Paper›PMID 37818490›Full record

ArticleCureus2023

Enteral Nutrition Versus Parenteral Nutrition on Outcomes in Acute Pancreatitis: Insights From the Nationwide Inpatient Sample.

Fidelis Uwumiro, Oluwatobi A Olaomi, Opeyemi Tobalesi, Victory Okpujie, Olawale Abesin, Enomen Ekata, Pascal Ezerioha, Uwakmfonabasi A Umoudoh, Zainab Olapade, Evaristus Asobara

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 4 countries.

Fidelis UwumiroInternal Medicine, Our Lady of Apostles Hospital, Akwanga, NGA.
Oluwatobi A OlaomiRadiology, University of Ibadan, Ibadan, NGA.
Opeyemi TobalesiInternal Medicine, College of Health Sciences, University of Ilorin, Ilorin, NGA.
Victory OkpujieInternal Medicine, Central Hospital Benin, Benin City, NGA.
Olawale AbesinInternal Medicine, Royal Cornwall Hospitals NHS Trust, Cornwall, GBR.
Enomen EkataInternal Medicine, Ambrose Alli University, Ekpoma, NGA.
Pascal EzeriohaInternal Medicine, Nnamdi Azikiwe University, Awka, NGA.
Uwakmfonabasi A UmoudohInternal Medicine, Southport and Formby District General Hospital, Southport, GBR.
Zainab OlapadeClinical Research, Lamar University, Beaumont, USA.
Evaristus AsobaraInternal Medicine, Nnamdi Azikiwe University, Awka, NGA.
Lamar University · USSungae Hospital · KRAmbrose Alli University · NGNnamdi Azikiwe University · NGRoyal Cornwall Hospital Trust · GBSouthport and Formby District General Hospital · GBUniversity of Ibadan · NG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite considerable research on the comparison of enteral and parenteral nutrition in patients with acute pancreatitis, there is an ongoing debate about the optimal timing of nutrition initiation, invasiveness of interventions, impact on outcomes, and patient tolerance. Given the gap that still exists in the literature, we investigated the relationship between the mode of nutrition and critical outcomes such as mortality rates, inpatient complications, length of hospitalization, and discharge disposition, using comprehensive national-level data. In addition, we investigated the impact of early enteral nutrition on outcomes in acute pancreatitis.

methodsAll adult discharges for acute pancreatitis between 2016 and 2018 were analyzed from the National (Nationwide) Inpatient Sample (NIS). Discharges of minors and those involving mixed nutrition were excluded from the analysis. Enteral nutrition and parenteral nutrition subgroups were identified using the International Classification of Diseases, 10th revision (ICD-10) codes. Disease severity was defined using the 2013 revised Atlanta Classification of Acute Pancreatitis, along with the All Patient Refined Diagnosis Related Group (APR-DRG)'s severity of illness and likelihood of mortality variables. Complications were identified using ICD-10 codes from the secondary diagnoses variables within the NIS dataset. Multivariable logistic regression analyses were employed to assess associations between the mode of nutrition and the outcomes of interest.

resultsA total of 379,410 hospitalizations were studied. About 2,011 (0.53%) received enteral nutrition, while 4,174 (1.1%) received parenteral nutrition. The mean age of the study was 51.7 years (SD 0.1). About 2,280 mortalities were recorded in the study. After adjustments, enteral nutrition was associated with significantly lower odds of mortality (adjusted OR (aOR): 0.833; 95%CI: 0.497-0.933; P<0.001). Parenteral nutrition was linked with significantly greater odds of mortality (aOR: 6.957; 95%CI: 4.730-10.233; P<0.001). Both enteral nutrition and parenteral nutrition were associated with augmented odds of complications and prolonged hospitalization (P<0.001) compared to normal oral feeding. Initiation of enteral nutrition within 24 hours of admission did not improve the odds of mortality in this study (aOR: 5.619; 95%CI: 1.900-16.615; P=0.002).

conclusionEnteral nutrition demonstrates better outcomes in mortality rates and systemic complications compared to parenteral nutrition in patients unable to maintain normal oral feeding.

Indexed as

acute pancreatitisenteral feedingnationwide inpatient samplepancreasparenteral nutrition

Identifiers

PMID37818490
PMCPMC10561903
OpenAlexW4386580006

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.