Effect and safety of nutritional supplements on clinical outcomes in patients with acute pancreatitis: a systematic review and network meta-analysis
Abstract
BACKGROUND: The effectiveness of nutritional supplements is controversial compared to standard supplementation in the clinical management of individuals with acute pancreatitis (AP). We performed a network meta-analysis (NMA) to compare and rank their efficacy. METHODS: Four databases (Web of Science, Cochrane, Embase, PubMed) were searched for randomized controlled trials. Random-effects models to derive outcome estimates, with risk ratios (RRs) and 95% confidence intervals (CIs) calculated for each comparison. The surface under the cumulative ranking (SUCRA) was used to rank the relative efficacy of all therapies. RESULTS: Seventeen trials including 1,313 patients were analyzed. ω-3 fatty acid supplementation emerged as the most effective intervention. It significantly shortened hospital stay (mean difference = -5.82 days; 95% CI -10.62 to -1.01) and intensive care unit (ICU) stay (mean difference = -6.09 days; 95% CI -8.98 to -3.20). It also reduced ICU stay in patients with severe acute pancreatitis (SAP) (mean difference = -6.09 days; 95% CI -8.98 to -3.02). Moreover, ω-3 fatty acids reduced the risk of sepsis (RR = 0.35; 95% CI 0.14–0.89) in AP and SAP (RR = 0.30; 95% CI 0.10–0.93). Synbiotics dramatically reduced the incidence of bacteremia (RR = 0.27; 95% CI = 0.09–0.86). It also reduced ICU stay with the enteral route (mean difference = -3.22 days; 95% CI, -3.95 to -2.49). However, none of the regimens produced significant improvements in mortality, infectious…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,313 participants or records.
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