Early feeding reduces hospital stay, costs in acute pancreatitis

Early oral feeding in patients with acute pancreatitis can help shorten the length of hospital stay (LOHS) and even lower the costs of medical care without increasing feeding intolerance or mortality, reports a study. In those with a severe disease, early feeding after 1 day appears beneficial.

In this systematic review and meta-analysis, investigators did a thorough search in electronic databases for studies comparing early with delayed feeding in acute pancreatitis. LOHS was the primary outcome, while secondary ones included intolerance of refeeding, mortality, and total cost of each patient. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISM) guideline was used.

Twenty trials involving a total of 2,168 patients met the eligibility criteria. Participants were randomized to either the early feeding group (n=1,033) or the delayed feeding group (n=1,135). Early feeding led to significantly shorter LOHS than delayed feeding (mean difference, ‒2.35, 95 percent confidence interval [C], ‒2.89 to ‒1.80; p<0.0001), irrespective of disease severity (p_int=0.69).

Feeding intolerance and mortality did not differ significantly between the two groups (early feeding: risk ratio [RR], 0.96, 95 percent CI, 0.40‒2.16; p=0.87; delayed feeding: RR, 0.91, 95 percent CI, 0.57‒1.46; p=0.69). Notably, the early feeding group generated a significantly less hospitalization cost, with an average savings reaching 50 percent.

In patients with severe pancreatitis, early feeding after 24 hours appeared to provide some beneficial effects (p_int=0.001).