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The impact of post-operative enteral nutrition on duodenal injury outcomes: A post hoc analysis of an EAST multicenter trial

Title: The impact of post-operative enteral nutrition on duodenal injury outcomes: A post hoc analysis of an EAST multicenter trial
Authors: Choron, Rachel L; Rallo, Michael; Piplani, Charoo; Youssef, Sara; Teichman, Amanda L; Bargoud, Christopher G; Sciarretta, Jason D; Smith, Randi N; Hanos, Dustin S; Afif, Iman N; Beard, Jessica H; Dhillon, Navpreet K; Zhang, Ashling; Ghneim, Mira; Devasahayam, Rebekah J; Gunter, Oliver L; Smith, Alison A; Sun, Brandi L; Cao, Chloe; Reynolds, Jessica K; Hilt, Lauren A; Holena, Daniel; Chang, Grace; Jonikas, Meghan; Echeverria, Karla; Fung, Nathaniel; Anderson, Aaron; Dumas, Ryan P; Fitzgerald, Caitlin A; Levin, Jeremy; Trankiem, Christine; Yoon, JaeHee Jane; Blank, Jacqueline; Hazelton, Joshua; McLaughlin, Christopher J; Al-Aref, Rami; Kirsch, Jordan M; Howard, Daniel S; Scantling, Dane R; Dellonte, Kate; Vella, Michael; Hopkins, Brent; Shell, Chloe; Udekwu, Pascal O; Wong, Evan G; Joseph, Bellal A; Lieberman, Howard; Ramsey, Walter; Stewart, Collin; Alvarez, Claudia; Berne, John D; Nahmias, Jeffry; Puente, Ivan; Patton, Joe H; Rakitin, Ilya; Perea, Lindsey L; Pulido, Odessa R; Ahmed, Hashim; Keating, Jane; Kodadek, Lisa; Wade, Jason; Henry, Reynold; Schreiber, Martin; Benjamin, Andrew; Khan, Abid; Mann, Laura K; Mentzer, Caleb; Mousafeiris, Vasileios; Mulita, Francesk; Reid-Gruner, Shari; Sais, Erica; Foote, Christopher; Palacio-Lascano, Carlos; Argandykov, Dias; Kaafarani, Haytham; Bover Manderski, Michelle; Narayan, Mayur; Seamon, Mark J
Source: Surgery Articles
Publisher Information: Henry Ford Health Scholarly Commons
Publication Year: 2024
Collection: Henry Ford Health System Scholarly Commons
Subject Terms: Humans; Male; Enteral Nutrition/methods/statistics & numerical data; Female; Adult; Retrospective Studies; Duodenum/injuries/surgery; Length of Stay/statistics & numerical data; Postoperative Complications/epidemiology/prevention & control; Parenteral Nutrition/methods/statistics & numerical data; Postoperative Care/methods; Trauma Centers; Middle Aged; Young Adult; Treatment Outcome; Duodenal injury; duodenal leak; enteral nutrition; pancreatic injury; parenteral nutrition
Description: BACKGROUND: Leak following surgical repair of traumatic duodenal injuries results in prolonged hospitalization and oftentimes nil per os(NPO) treatment. Parenteral nutrition(PN) has known morbidity; however, duodenal leak(DL) patients often have complex injuries and hospital courses resulting in barriers to enteral nutrition(EN). We hypothesized EN alone would be associated with 1)shorter duration until leak closure and 2)less infectious complications and shorter hospital length of stay(HLOS) compared to PN. METHODS: This was a post-hoc analysis of a retrospective, multicenter study from 35 Level-1 trauma centers, including patients >14 years-old who underwent surgery for duodenal injuries(1/2010-12/2020) and endured post-operative DL. The study compared nutrition strategies: EN vs PN vs EN + PN using Chi-Square and Kruskal-Wallis tests; if significance was found pairwise comparison or Dunn's test were performed. RESULTS: There were 113 patients with DL: 43 EN, 22 PN, and 48 EN + PN. Patients were young(median age 28 years-old) males(83.2%) with penetrating injuries(81.4%). There was no difference in injury severity or critical illness among the groups, however there were more pancreatic injuries among PN groups. EN patients had less days NPO compared to both PN groups(12 days[IQR23] vs 40[54] vs 33[32],p =
Document Type: text
Language: unknown
Relation: https://scholarlycommons.henryford.com/surgery_articles/808; https://libkey.io/libraries/106/38745354
Availability: https://scholarlycommons.henryford.com/surgery_articles/808; https://libkey.io/libraries/106/38745354
Accession Number: edsbas.8B6983BC
Database: BASE