Exclusive enteral nutrition and the risk of nonsurgical readmission in patients with Crohn's disease-related intra-abdominal abscess: A retrospective cohort study.

BACKGROUND

Intra-abdominal abscess management in Crohn's disease patients represents a significant clinical challenge. This study sought to assess the impact of exclusive enteral nutrition on nonsurgical readmission in patients with Crohn's disease-related intra-abdominal abscess.

METHODS

This retrospective cohort study was conducted between January 2016 and June 2022 included Crohn's disease patients hospitalized for intra-abdominal abscess. Patients were categorized based on exclusive enteral nutrition administration during hospital stay or not. The primary outcome was nonsurgical readmission within 1-year post-discharge. Secondary outcomes included surgical intervention and abscess recurrence. Multivariable logistic regression analysis and Cox regression analysis were performed to adjust for potential confounding factors.

RESULTS

A total of 128 patients were enrolled, with 45 allocated to the exclusive enteral nutrition group and 83 to the nonexclusive enteral nutrition group. Compared to the nonexclusive enteral nutrition group, patients treated with exclusive enteral nutrition were less likely to require nonsurgical readmissions (42.2% vs 79.5%, P < 0.001). The multivariate analysis confirmed exclusive enteral nutrition as an independent protective factor against nonsurgical readmissions (hazard ratio: 0.11; 95% confidence interval: 0.04-0.30; P < 0.001). In addition, exclusive enteral nutrition group showed a significantly lower rate of surgical intervention (46.7% vs 75.9%, P = 0.01). Notably, abscess recurrence rates remained comparable between groups.

CONCLUSION

This study provides novel evidence that exclusive enteral nutrition is associated with reduced risks of nonsurgical readmission and surgical burden without affecting abscess recurrence rates in patients with Crohn's disease-related intra-abdominal abscess.