A retrospective cohort study of nutritional status, nutritional interventions and hospital admissions in patients with chronic pancreatitis managed at a tertiary referral centre.

Abstract

Chronic pancreatitis (CP) is a complex disease process causing abdominal pain, diarrhoea and weight loss. The long-term nutritional implications however are not well documented. The aim of this study was to evaluate nutritional status in patients with CP over an extended time period and assess frequency and duration of CP related hospitalisation. Retrospective analysis of patients with known CP for nutritional status (weight, BMI, and weight changes), nutritional interventions and hospital admissions were recorded. Weight was recorded at 3 points; baseline consultation, first review and most recent consultations. Number of dietitian contacts and documented evidence of nutritional advice/interventions were recorded and grouped. Nutritional status was compared in those who had dietetic input with those who did not. 46 consecutive subjects (34/46 male, mean age 56.15 years, 26/46 alcohol aetiology) were followed up for a mean of 5.24 years. 38/46 lost weight from baseline to review with mean percentage weight change: baseline to review=-7.36, p<0.0001, baseline to recent=-6.70, p=0.003, review to recent=1.47, p=0.581. 23/46 were reviewed by dietitian (mean 4.65 reviews). The number of dietitian reviews were positively associated with weight gain; baseline to recent (p=0.010) and review to recent (p=0.011). 23/46 received nutritional advice/interventions with 11 requiring enteral feeding. 29/46 experienced unplanned CP related hospital admissions (median 3) comprising 30 median total admission days. Patients with CP lose a significant amount of weight in a short time period which plateaus. Dietitian review is associated with improved nutritional status in CP.