Clinical nutrition ESPEN · 2026
Energy metabolism in acute pancreatitis: Accuracy of the Harris-Benedict equation vs. indirect calorimetry and impact of nutritional support on post-discharge functional limitation.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Wang Xiancong, Wang Jie, Sun Jian, Huang Xi, Xia Honghai, Wang Ying, Chen Yanyan, Wang Youcai, Fang Wei, Zhou Shusheng, Jin Kui
Аннотация
BACKGROUND & AIMS: This study investigates early energy metabolism in patients with acute pancreatitis (AP) comparing the accuracy of the Harris-Benedict equation (HBE) and indirect calorimetry (IC) for predicting resting energy expenditure (REE). Additionally, the impact of clinical nutritional prescription on AP severity and the development of post-discharge functional limitation (PDFL) was also assessed.
METHODS: A retrospective observational study was performed involving AP patients admitted to the Emergency Surgery Department of the First Affiliated Hospital of the University of Science and Technology of China between July 2022 and December 2023. IC was used as the reference standard for measuring energy expenditure, and the accuracy of the HBE in predicting REE was evaluated in both AP patients and healthy controls. Nutritional prescriptions during hospitalization were collected, with the primary endpoint being the occurrence of post-discharge functional limitation (PDFL) within 7 days after discharge. Independent risk factors for PDFL were also analyzed.
RESULTS: The HBE significantly underestimated REE in AP patients compared to healthy controls. AP patients with hypertriglyceridemia-induced pancreatitis exhibited higher REE and greater energy deficits, indicating more severe disease. Low albumin levels and inadequate energy prescriptions were identified as independent risk factors for PDFL. The discrepancy between prescribed and required caloric intake was significantly associated with the incidence of PDFL.
CONCLUSION: The HBE may not be reliable for predicting REE in AP patients. Inadequate caloric intake is strongly associated with PDFL. Individualized nutritional support, guided by IC, may improve clinical outcomes.
METHODS: A retrospective observational study was performed involving AP patients admitted to the Emergency Surgery Department of the First Affiliated Hospital of the University of Science and Technology of China between July 2022 and December 2023. IC was used as the reference standard for measuring energy expenditure, and the accuracy of the HBE in predicting REE was evaluated in both AP patients and healthy controls. Nutritional prescriptions during hospitalization were collected, with the primary endpoint being the occurrence of post-discharge functional limitation (PDFL) within 7 days after discharge. Independent risk factors for PDFL were also analyzed.
RESULTS: The HBE significantly underestimated REE in AP patients compared to healthy controls. AP patients with hypertriglyceridemia-induced pancreatitis exhibited higher REE and greater energy deficits, indicating more severe disease. Low albumin levels and inadequate energy prescriptions were identified as independent risk factors for PDFL. The discrepancy between prescribed and required caloric intake was significantly associated with the incidence of PDFL.
CONCLUSION: The HBE may not be reliable for predicting REE in AP patients. Inadequate caloric intake is strongly associated with PDFL. Individualized nutritional support, guided by IC, may improve clinical outcomes.