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Better care reduces time to successful refeeding in acute pancreatitis
Enhanced recovery approaches were safe and effective at promoting earlier restoration of gut function in acute pancreatitis patients, according to a study presented at the World Congress of Gastroenterology at ACG 2017.
Patients recruited for the trial were admitted directly from an emergency department and received either enhanced care consisting of patient-directed oral intake, early ambulation, and nonopioid analgesia or received normal care consisting of opioid analgesia, physician-directed diet, and nursing parameters, Elizabeth Dong, MD, of the Kaiser Permanente Los Angeles Medical Center and her associates said.
Among the 46 patients included in the study, 61% had an etiology of gallstones, 15% had an etiology of alcohol, 13% had hyperglyceridemia, and 11% had a different etiology. Median age was 53.1 years, Dr. Dong and her associates noted.
Time to successful oral refeeding, the primary study endpoint, was significantly reduced in the enhanced treatment group, with a median time of 13.8 hours, compared with the normal treatment group, in which median time to oral refeeding was 124.8 hours. In addition, patients in the enhanced care group had a mean pancreatitis activity score of 43.5 after 48-72 hours, while patients in the control group had a mean score of 72.1.
Length of stay and frequency of 30-day readmission did not differ significantly between study groups.
The study was not funded by industry grants, and no disclosures were reported.
Enhanced recovery approaches were safe and effective at promoting earlier restoration of gut function in acute pancreatitis patients, according to a study presented at the World Congress of Gastroenterology at ACG 2017.
Patients recruited for the trial were admitted directly from an emergency department and received either enhanced care consisting of patient-directed oral intake, early ambulation, and nonopioid analgesia or received normal care consisting of opioid analgesia, physician-directed diet, and nursing parameters, Elizabeth Dong, MD, of the Kaiser Permanente Los Angeles Medical Center and her associates said.
Among the 46 patients included in the study, 61% had an etiology of gallstones, 15% had an etiology of alcohol, 13% had hyperglyceridemia, and 11% had a different etiology. Median age was 53.1 years, Dr. Dong and her associates noted.
Time to successful oral refeeding, the primary study endpoint, was significantly reduced in the enhanced treatment group, with a median time of 13.8 hours, compared with the normal treatment group, in which median time to oral refeeding was 124.8 hours. In addition, patients in the enhanced care group had a mean pancreatitis activity score of 43.5 after 48-72 hours, while patients in the control group had a mean score of 72.1.
Length of stay and frequency of 30-day readmission did not differ significantly between study groups.
The study was not funded by industry grants, and no disclosures were reported.
Enhanced recovery approaches were safe and effective at promoting earlier restoration of gut function in acute pancreatitis patients, according to a study presented at the World Congress of Gastroenterology at ACG 2017.
Patients recruited for the trial were admitted directly from an emergency department and received either enhanced care consisting of patient-directed oral intake, early ambulation, and nonopioid analgesia or received normal care consisting of opioid analgesia, physician-directed diet, and nursing parameters, Elizabeth Dong, MD, of the Kaiser Permanente Los Angeles Medical Center and her associates said.
Among the 46 patients included in the study, 61% had an etiology of gallstones, 15% had an etiology of alcohol, 13% had hyperglyceridemia, and 11% had a different etiology. Median age was 53.1 years, Dr. Dong and her associates noted.
Time to successful oral refeeding, the primary study endpoint, was significantly reduced in the enhanced treatment group, with a median time of 13.8 hours, compared with the normal treatment group, in which median time to oral refeeding was 124.8 hours. In addition, patients in the enhanced care group had a mean pancreatitis activity score of 43.5 after 48-72 hours, while patients in the control group had a mean score of 72.1.
Length of stay and frequency of 30-day readmission did not differ significantly between study groups.
The study was not funded by industry grants, and no disclosures were reported.
FROM WORLD CONGRESS OF GASTROENTEROLOGY
Key clinical point:
Major finding: Median time to successful oral refeeding was more than 4 days faster in patients who received enhanced care.
Data source: A pilot single-blind, randomized, controlled trial of 46 patients admitted from an emergency department between July 2016 and April 2017.
Disclosures: The study was not funded by industry grants, and no disclosures were reported.
Serrated polyps alone not associated with future high-risk adenomas
The presence of serrated polyps on index colonoscopies without low-risk adenomas was not associated with metachronous high-risk adenomas on surveillance exams, according to a study presented at the World Congress of Gastroenterology at ACG 2017.
Data for the study were collected from 4,616 adults who had two colonoscopies on record with the New Hampshire Colonoscopy Registry. Patients with high-risk adenomas at the index colonoscopy were excluded from the study. The median time between index and surveillance exams was 4.9 years, and median age was 61 years, according to Joseph Anderson, MD, of Geisel School of Medicine at Dartmouth, Hanover, N.H., and his associates.
Overall, the risk for metachronous high-risk adenomas in the study group was 6.3% and the risk of large serrated polyps greater than or equal to 1 cm was 1.2%. After patient age, sex, smoking, body mass index, and time between the two exams were adjusted for, low-risk adenomas at the time of the index colonoscopy were associated with an increased metachronous risk of high-risk adenomas, Dr. Anderson and his colleagues noted.
Large serrated polyps and the presence of sessile serrated polyps or traditional serrated adenomas at index exam increased the risk of metachronous serrated polyps at the surveillance colonoscopy 10-fold and 14-fold, respectively, but did not increase the risk of high-risk adenomas. The presence of both low-risk adenomas and significant serrated polyps was not associated with an increased risk of high-risk adenomas over the presence of low-risk adenomas alone.
The study was not funded by industry grants, and no disclosures were reported.
The presence of serrated polyps on index colonoscopies without low-risk adenomas was not associated with metachronous high-risk adenomas on surveillance exams, according to a study presented at the World Congress of Gastroenterology at ACG 2017.
Data for the study were collected from 4,616 adults who had two colonoscopies on record with the New Hampshire Colonoscopy Registry. Patients with high-risk adenomas at the index colonoscopy were excluded from the study. The median time between index and surveillance exams was 4.9 years, and median age was 61 years, according to Joseph Anderson, MD, of Geisel School of Medicine at Dartmouth, Hanover, N.H., and his associates.
Overall, the risk for metachronous high-risk adenomas in the study group was 6.3% and the risk of large serrated polyps greater than or equal to 1 cm was 1.2%. After patient age, sex, smoking, body mass index, and time between the two exams were adjusted for, low-risk adenomas at the time of the index colonoscopy were associated with an increased metachronous risk of high-risk adenomas, Dr. Anderson and his colleagues noted.
Large serrated polyps and the presence of sessile serrated polyps or traditional serrated adenomas at index exam increased the risk of metachronous serrated polyps at the surveillance colonoscopy 10-fold and 14-fold, respectively, but did not increase the risk of high-risk adenomas. The presence of both low-risk adenomas and significant serrated polyps was not associated with an increased risk of high-risk adenomas over the presence of low-risk adenomas alone.
The study was not funded by industry grants, and no disclosures were reported.
The presence of serrated polyps on index colonoscopies without low-risk adenomas was not associated with metachronous high-risk adenomas on surveillance exams, according to a study presented at the World Congress of Gastroenterology at ACG 2017.
Data for the study were collected from 4,616 adults who had two colonoscopies on record with the New Hampshire Colonoscopy Registry. Patients with high-risk adenomas at the index colonoscopy were excluded from the study. The median time between index and surveillance exams was 4.9 years, and median age was 61 years, according to Joseph Anderson, MD, of Geisel School of Medicine at Dartmouth, Hanover, N.H., and his associates.
Overall, the risk for metachronous high-risk adenomas in the study group was 6.3% and the risk of large serrated polyps greater than or equal to 1 cm was 1.2%. After patient age, sex, smoking, body mass index, and time between the two exams were adjusted for, low-risk adenomas at the time of the index colonoscopy were associated with an increased metachronous risk of high-risk adenomas, Dr. Anderson and his colleagues noted.
Large serrated polyps and the presence of sessile serrated polyps or traditional serrated adenomas at index exam increased the risk of metachronous serrated polyps at the surveillance colonoscopy 10-fold and 14-fold, respectively, but did not increase the risk of high-risk adenomas. The presence of both low-risk adenomas and significant serrated polyps was not associated with an increased risk of high-risk adenomas over the presence of low-risk adenomas alone.
The study was not funded by industry grants, and no disclosures were reported.
FROM THE 13TH WORLD CONGRESS OF GASTROENTEROLOGY
Key clinical point:
Major finding: After patient age, sex, smoking, body mass index, and time between index and surveillance exams were adjusted for, the presence of index serrated polyps without additional low-risk adenomas did not increase risk of high-risk adenomas at surveillance exams.
Data source: Data collected from 4,616 patients in the New Hampshire Colonoscopy Registry.
Disclosures: The study was not funded by industry grants, and no disclosures were reported.
Watch for our breaking news coverage
GI & Hepatology News will be in Orlando next week at the Orange County Convention Center reporting the latest news from the World Congress of Gastroenterology at ACG 2017. Studies slated for presentation will detail new findings in every area of clinical concern to the gastroenterologist.
Our onsite reporters will cover new drugs and treatment regimens in inflammatory bowel disease, endoscopic advances for treatment along the GI tract, and novel tests and biomarkers for various disease states.
Highly anticipated presentations include:
- Risk of metachronous high-risk adenomas and large (greater than or equal to 1 cm) serrated polyps in individuals with serrated polyps on index colonoscopy: Longitudinal data from the New Hampshire Colonoscopy Registry.
- Enhanced recovery in acute pancreatitis (RAPTor): A randomized controlled trial.
- A prospective validation of deep learning for polyp autodetection during colonoscopy.
GI & Hepatology News will be in Orlando next week at the Orange County Convention Center reporting the latest news from the World Congress of Gastroenterology at ACG 2017. Studies slated for presentation will detail new findings in every area of clinical concern to the gastroenterologist.
Our onsite reporters will cover new drugs and treatment regimens in inflammatory bowel disease, endoscopic advances for treatment along the GI tract, and novel tests and biomarkers for various disease states.
Highly anticipated presentations include:
- Risk of metachronous high-risk adenomas and large (greater than or equal to 1 cm) serrated polyps in individuals with serrated polyps on index colonoscopy: Longitudinal data from the New Hampshire Colonoscopy Registry.
- Enhanced recovery in acute pancreatitis (RAPTor): A randomized controlled trial.
- A prospective validation of deep learning for polyp autodetection during colonoscopy.
GI & Hepatology News will be in Orlando next week at the Orange County Convention Center reporting the latest news from the World Congress of Gastroenterology at ACG 2017. Studies slated for presentation will detail new findings in every area of clinical concern to the gastroenterologist.
Our onsite reporters will cover new drugs and treatment regimens in inflammatory bowel disease, endoscopic advances for treatment along the GI tract, and novel tests and biomarkers for various disease states.
Highly anticipated presentations include:
- Risk of metachronous high-risk adenomas and large (greater than or equal to 1 cm) serrated polyps in individuals with serrated polyps on index colonoscopy: Longitudinal data from the New Hampshire Colonoscopy Registry.
- Enhanced recovery in acute pancreatitis (RAPTor): A randomized controlled trial.
- A prospective validation of deep learning for polyp autodetection during colonoscopy.
Coming soon!
Watch for our onsite coverage of the World Congress of Gastroenterology (WCOG), Oct. 13-18.
Watch for our onsite coverage of the World Congress of Gastroenterology (WCOG), Oct. 13-18.
Watch for our onsite coverage of the World Congress of Gastroenterology (WCOG), Oct. 13-18.