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A systematic review and meta-analysis of the effect of total parenteral nutrition and enteral nutrition on the prognosis of patients with acute pancreatitis.
Ann Palliat Med. 2021 10; 10(10):10779-10788.AP

Abstract

BACKGROUND

Nutritional support is very important in the treatment of severe acute pancreatitis, this study aimed to investigate the effect of total parenteral nutrition (TPN) and enteral nutrition (TEN) on the prognosis of patients with acute pancreatitis.

METHODS

The databases of PubMed, Embase, Cochrane Library, and Ovid were searched using the keywords acute pancreatitis, enteral nutrition, and parenteral nutrition to obtain the reports of randomized controlled trials (RCTs) published after 2000. After screening the articles according to the inclusion criteria, risk of bias of the included literatures was evaluated using the Cochrane Handbook for Systematic Reviews. The software RevMan 5.3.5 was used for analysis and the creation of a forest plot and funnel plot.

RESULTS

A total of 488 literatures were preliminarily searched in this study, from which 10 articles were included into the final quantitative analysis, involving a total of 699 participants. A total of 6 literatures (n=329 participants) reported the infection rate indicators. The obtained statistic value [odds ratio (OR) =0.25, 95% confidence interval (CI): 0.10 to 0.62] showed TEN had less infection rate that TPN (P=0.003). A total of 8 studies (654 participants) reported the incidence rate indicators of multiple organ failure rate indicator, the obtained statistic value (OR =0.50, 95% CI: 0.24 to 1.08) showed no statistical difference between TEN and TPN (P>0.05). A total of 7 studies (550 participants) reported the mortality indicators. The obtained statistic value (OR =0.59, 95% CI: 0.37 to 0.94) showed TEN had less mortality than TPN (P=0.03). A total of 3 studies reported the length of hospital stay indicators. The obtained statistic value [mean difference (MD) -4.18, 95% CI: -5.07 to -3.30] showed the length of hospital stay for TEN was shorter that TPN (P<0.001).

DISCUSSION

Compared with TPN, TEN can reduce the incidence of infection, reduce the development of multiple organ failure, reduce mortality, and shorten the length of hospital stay in patients with severe acute pancreatitis (SAP). However, attention should be paid to prevent the occurrence of complications during the implementation of nutritional intervention.

Authors+Show Affiliations

Emergency Department, The Affiliated Chengdu 363 Hospital of Southwest Medical University, Chengdu, China.Department of Emergency Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

34763439

Citation

Liu, Mingshuang, and Cong Gao. "A Systematic Review and Meta-analysis of the Effect of Total Parenteral Nutrition and Enteral Nutrition On the Prognosis of Patients With Acute Pancreatitis." Annals of Palliative Medicine, vol. 10, no. 10, 2021, pp. 10779-10788.
Liu M, Gao C. A systematic review and meta-analysis of the effect of total parenteral nutrition and enteral nutrition on the prognosis of patients with acute pancreatitis. Ann Palliat Med. 2021;10(10):10779-10788.
Liu, M., & Gao, C. (2021). A systematic review and meta-analysis of the effect of total parenteral nutrition and enteral nutrition on the prognosis of patients with acute pancreatitis. Annals of Palliative Medicine, 10(10), 10779-10788. https://doi.org/10.21037/apm-21-2469
Liu M, Gao C. A Systematic Review and Meta-analysis of the Effect of Total Parenteral Nutrition and Enteral Nutrition On the Prognosis of Patients With Acute Pancreatitis. Ann Palliat Med. 2021;10(10):10779-10788. PubMed PMID: 34763439.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A systematic review and meta-analysis of the effect of total parenteral nutrition and enteral nutrition on the prognosis of patients with acute pancreatitis. AU - Liu,Mingshuang, AU - Gao,Cong, PY - 2021/08/13/received PY - 2021/09/24/accepted PY - 2021/11/12/entrez PY - 2021/11/13/pubmed PY - 2021/11/16/medline KW - Total parenteral nutrition (TPN) KW - acute pancreatitis KW - enteral nutrition KW - meta-analysis SP - 10779 EP - 10788 JF - Annals of palliative medicine JO - Ann Palliat Med VL - 10 IS - 10 N2 - BACKGROUND: Nutritional support is very important in the treatment of severe acute pancreatitis, this study aimed to investigate the effect of total parenteral nutrition (TPN) and enteral nutrition (TEN) on the prognosis of patients with acute pancreatitis. METHODS: The databases of PubMed, Embase, Cochrane Library, and Ovid were searched using the keywords acute pancreatitis, enteral nutrition, and parenteral nutrition to obtain the reports of randomized controlled trials (RCTs) published after 2000. After screening the articles according to the inclusion criteria, risk of bias of the included literatures was evaluated using the Cochrane Handbook for Systematic Reviews. The software RevMan 5.3.5 was used for analysis and the creation of a forest plot and funnel plot. RESULTS: A total of 488 literatures were preliminarily searched in this study, from which 10 articles were included into the final quantitative analysis, involving a total of 699 participants. A total of 6 literatures (n=329 participants) reported the infection rate indicators. The obtained statistic value [odds ratio (OR) =0.25, 95% confidence interval (CI): 0.10 to 0.62] showed TEN had less infection rate that TPN (P=0.003). A total of 8 studies (654 participants) reported the incidence rate indicators of multiple organ failure rate indicator, the obtained statistic value (OR =0.50, 95% CI: 0.24 to 1.08) showed no statistical difference between TEN and TPN (P>0.05). A total of 7 studies (550 participants) reported the mortality indicators. The obtained statistic value (OR =0.59, 95% CI: 0.37 to 0.94) showed TEN had less mortality than TPN (P=0.03). A total of 3 studies reported the length of hospital stay indicators. The obtained statistic value [mean difference (MD) -4.18, 95% CI: -5.07 to -3.30] showed the length of hospital stay for TEN was shorter that TPN (P<0.001). DISCUSSION: Compared with TPN, TEN can reduce the incidence of infection, reduce the development of multiple organ failure, reduce mortality, and shorten the length of hospital stay in patients with severe acute pancreatitis (SAP). However, attention should be paid to prevent the occurrence of complications during the implementation of nutritional intervention. SN - 2224-5839 UR - https://www.unboundmedicine.com/medline/citation/34763439/A_systematic_review_and_meta_analysis_of_the_effect_of_total_parenteral_nutrition_and_enteral_nutrition_on_the_prognosis_of_patients_with_acute_pancreatitis_ L2 - https://doi.org/10.21037/apm-21-2469 DB - PRIME DP - Unbound Medicine ER -
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