P3442 - Impact of Early Refeeding of Patients With Acute Non-Gallstone Pancreatitis: A Quality Assessment Study

Amanda Jacubowsky, DO¹, William Ghaul, DO¹, Travis Magdaleno, DO¹, Kathryn Zaffiri, MPH¹, Shashin Shah, MD^2
1Lehigh Valley Health Network, Allentown, PA; ²Eastern Pennsylvania Gastrointestinal and Liver Specialists, Allentown, PA

Introduction: Acute pancreatitis is a condition that affects 220,000 people in the United States each year. Newer research favors early re-feeding to replenish energy stores and reduce adverse outcomes. This quality assessment study aims to investigate patterns of re-feeding and length of stay (LOS) for patients with acute mild to moderate pancreatitis at a large tertiary referral center.

Methods: A query was performed via the Epic electronic medical record system to identify all patients diagnosed with acute pancreatitis from July 2022 through December 2022. Additional information retrieved included the patient’s admission and discharge dates with their calculated LOS. Patients with gallstone pancreatitis, severe necrotizing pancreatitis, chronic pancreatitis, and those under the age of 18 were excluded from the study. A chart review was performed to assess for appropriate diagnosis of mild to moderate pancreatitis via the Atlanta Criteria, etiology of pancreatitis, date of first diet, date a goal low-fat gastrointestinal diet was achieved, and reasons for delaying diet initiation. Data analysis involved descriptive statistics using Microsoft Excel.

Results: An Epic query enlisted 130 patients in the quality improvement study. Of the identified patients, 47 met the exclusion criteria. In the remaining 83 patients, the most common etiology of pancreatitis included alcohol- or medication-induced. The average day of hospitalization when the first clear liquid diet was started was 1.5 ± 0.74 days, and the date the goal low-fat diet was achieved was 2.75 ± 1.45 days. The reasons for delays in early re-feeding included inadequate pain control and delayed orders placed by the provider to reach the goal diet. The average LOS was 3.78 ± 3.42 days, with 22 patients exceeding 4 inpatient admission days.

Discussion: The patients in this quality assessment study had an average LOS of 3.78 ± 3.42 days, which is below the national average LOS of 4 days. This may be attributed to early initiation of re-feeding with most patients receiving first clear liquid diet on day 1.5 ± 0.74. Of the eligible patients in the study, 22 (26.5%) were hospitalized for more than 4 days. Factors that delayed discharge from the hospital included inadequate pain control and a slow initiation of re-feeding by providers. A multi-faceted approach including education on current recommendations for acute mild to moderate pancreatitis can be established to help shorten hospital LOS and minimize risk for hospital-acquired patient complications.


Disclosures:


Amanda Jacubowsky, DO¹, William Ghaul, DO¹, Travis Magdaleno, DO¹, Kathryn Zaffiri, MPH¹, Shashin Shah, MD². P3442 - Impact of Early Refeeding of Patients With Acute Non-Gallstone Pancreatitis: A Quality Assessment Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.