ArticleiGIE : innovation, investigation and insights2024
Comparative analysis of early versus late feeding after an EGD-based intervention: meta-analysis.
Article in iGIE : innovation, investigation and insights, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
Funding
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Abstract
Background and Aims: The right time to restart feeding after EGD-based interventions is not well established. However, impaired nutrition from prolonged fasting may lead to unfavorable clinical outcomes. Herein, we performed a systematic review and meta-analysis to study the impact of early feeding (within 24 hours) versus late feeding (>24 hours) in patients undergoing acute therapeutic EGD-based interventions. Methods: Multiple databases, including MEDLINE, Scopus, and Embase, were searched (in May 2022) using specific terms for studies evaluating the outcomes of early versus late feeding after EGD-based interventions. Outcomes of interest were early recurrent bleed (<7 days), late recurrent bleed (>7 days), mortality rates, length of hospital stay, and rate of blood transfusion. Standard meta-analysis methods were used using the random-effects model. Results: Eight studies (813 patients) were included in the final analysis. The "early feeding" cohort included 411 patients (31% women) with a mean age of 58 years, and the "late feeding" cohort included 402 patients (26.4% women) with a mean age of 57 years. Four studies (283 patients) evaluated patients with band ligation/sclerotherapy in acute variceal bleeding (224 patients), 2 studies (309 patients) with endoscopic treatment of peptic ulcer bleeding, and 2 studies in endoscopic mucosal dissection for gastric mucosal epithelial neoplasia. The pooled risk ratio (RR) of early recurrent bleeding in early feeding versus late feeding was 1.6 (95% confidence interval [CI], .7-3.7; Conclusions: Our meta-analysis demonstrates early enteral feeding within 24 hours does not appear to have a higher risk of recurrent bleeding and mortality than delayed enteral feeding in patients undergoing EGD-based therapeutic interventions. However, early feeding is associated with a shorter length of hospital stay compared with late feeding.
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