Analysis Of Influencing Factors Of Early Oral Eating Intolerance In Patients With Acute Pancreatitis

Objective:Early oral feeding intolerance(EOFI)is a well-known complication of acute pancreatitis(AP).several studies in AP have evaluated potential predictors of EOFI,but none of these studies have been applied to clinical practice.Therefore,In this study,the risk factors and predictors of EOFI were determined by analyzing and comparing the general and clinical data of AP patients with EOFI and early oral feeding tolerance.Provide a reference basis for different individuals to choose the best time to eat.Methods:The clinical data of 1129 AP patients admitted to Hebei General Hospital from January 2013 to December 2022 were retrospectively analyzed.Early feeding was defined as feeding within 72 h of patient onset.Patients were divided into the EOFI group(n = 180)and the early oral intake tolerance group(n = 949)based on whether abdominal pain and / or vomiting became worse after early oral feeding.First of all,univariate analysis is carried out to test the relationship between univariate and EOFI.Including age,sex,etiology,body mass index(BMI),smoking,drinking,order of severity,blood urea nitrogen(BUN)and hematocrit(HCT)levels on admission,white blood cell(WBC)and C-reactive protein(CRP)levels before eating,systemic inflammatory response syndrome(SIRS)positive on admission and SIRS 48 hours after admission,Length of hospital stay,mortality,and intensive care unit(ICU)admission.Then a multivariate Logistic regression model was established to determine the independent risk factors of EOFI and draw the subject working characteristic curve(ROC)to evaluate the significance of different indicators in the prediction of EOFI.Results:1.Among the 1129 AP patients enrolled in the study,the incidence of early oral eating intolerance was 15.9%.Found out when performing a univariate analysis,that non-biliary causes were more common in the EOFI group than in the tolerance group(68.9% vs 54.2%,P < 0.05).In the EOFI group,mild acute pancreatitis accounted for 55%,moderate severe acute pancreatitis accounted for 31%,severe acute pancreatitis accounted for14%;in the tolerance group,mild acute pancreatitis accounted for 71%,moderate severe acute pancreatitis accounted for 23%,severe acute pancreatitis accounted for 6%,the difference was statistically significant(P< 0.001).It was also found on admission SIRS,48 h SIRS were more common in the EOFI group than in the tolerance group,the difference was statistically significant(P < 0.001).Compared with the tolerance group,patients in the EOFI group showed longer hospital stay,higher frequency of admission to ICU,higher mortality,the difference was statistically significant(P < 0.001).There was significant difference in the levels of WBC and CRP between EOFI group and tolerated group at admission(P<0.05).In addition,there was no significant difference in sex,age,BMI,alcoholism,active smoking,BUN,HCT,AMS between the two groups(P>0.05).2.In multivariate Logistic regression analysis,differences in SIRS,biliary factors,HCT,and BUN were not statistically significant(P> 0.05),while 48 h SIRS,non-biliary factors,biochemical indicators WBC and CRP levels were statistically significant(P <0.05).3.ROC analysis showed that the area under the WBC curve was 0.632 and the CRP curve was 0.657;both WBC and CRP had predictive value for EOFI in AP patients.Conclusion:1.The incidence of EOFI is 15.9%,which is a relatively common complication during hospitalization in AP patients.The incidence of oral feeding intolerance is significantly higher in patients with severe acute pancreatitis than in patients with mild acute pancreatitis.Patients in the EOFI group showed longer hospitalization,higher frequency of ICU admission,and higher mortality than those in the tolerance group.2.48 h SIRS,Non-biliary etiology,WBC and CRP levels before eating,were independent risk factors for the development of EOFI.3.Both WBC and CRP had predictive value for EOFI.