Nomogram for predicting oral feeding intolerance in patients with acute pancreatitis

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 gastro...

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Published in:Nutrition (Burbank, Los Angeles County, Calif.) Vol. 36; pp. 41 - 45
Main Authors: Bevan, Melody G., Asrani, Varsha M., Pendharkar, Sayali A., Goodger, Rachel L., Windsor, John A., Petrov, Maxim S.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.04.2017
Elsevier Limited
Subjects:
Acute Disease
Acute pancreatitis
Adolescent
Adult
adults
Aged
Aged, 80 and over
cohort studies
confidence interval
Confidence intervals
diabetes
Diabetes mellitus
Diet
Endpoint Determination
Etiology
Feeding
Feeding and Eating Disorders - etiology
Feeding and Eating Disorders - therapy
Female
Gastroenterology
Gastroenterology and Hepatology
Gastrointestinal diseases
gastrointestinal system
Gastroparesis - etiology
Gastroparesis - therapy
Hospitalization
hospitals
Humans
Intolerance
Logistic Models
Male
Malnutrition
Middle Aged
Multivariate Analysis
Nausea
Nausea - etiology
Nausea - therapy
Nomogram
Nomograms
Nutrition
odds ratio
Pain
Pancreas
Pancreatitis
Pancreatitis - complications
Pancreatitis - therapy
Patients
Prediction
Prospective Studies
Quality of Life
Regression analysis
Risk Factors
Satiety
Severity of Illness Index
Treatment Outcome
Vomiting
Vomiting - etiology
Vomiting - therapy
Young Adult
Acute pancreatitis
Nutrition
Nomogram
Prediction
ISSN:0899-9007, 1873-1244, 1873-1244
Online Access:Get full text
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Summary: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. 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. 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). 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. •Gastrointestinal dysmotility is associated with oral feeding intolerance in acute pancreatitis.•The gastroparesis cardinal symptom index is a potentially useful tool to predict risk for oral feeding intolerance.•A predictive nomogram for risk for oral feeding intolerance has been developed.
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ISSN:0899-9007
1873-1244
1873-1244
DOI:10.1016/j.nut.2016.06.008