P1468 - The Effect of Aggressive Intravenous Fluid Resuscitation on the Mortality Outcome in Patients with Acute Pancreatitis: A Systematic Review and Meta-Analysis

Thanita Thongtan, MD¹, Asif Zamir, MD, FACG^2
1University of Texas Rio Grande Valley, Edinburg, TX; ²DHR Health Gastroenterology, Edinburg, TX

Introduction: Although aggressive intravenous (IV) fluid resuscitation has been generally recommended in patients with acute pancreatitis, there is growing evidence to the contrary suggesting that this practice is associated with poorer outcomes. The purpose of this meta-analysis was to combine the findings of existing relevant studies to investigate the mortality outcome of aggressive versus non-aggressive IV fluid resuscitation in patients with acute pancreatitis.

Methods: We conducted a systematic literature search in PubMed, EMBASE, and Scopus databases from inception to November 2022 to identify all original studies that investigated the impact of aggressive IV fluid resuscitation on the mortality outcome. Data from each study was combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate pooled odds ratio (OR) and 95% confidence intervals (CI).

Results: Of the 355 studies identified, 14 studies were included in this study, with a total of 1,695 and 2,541 patients receiving aggressive and non-aggressive IV fluid resuscitation, respectively. There were no significant differences in mortality between the two groups with pooled OR of 1.47 (95% CI: 0.97-2.22, p = 0.085) (Figure 1).

Discussion: While aggressive IV fluid resuscitation may or may not provide a clear benefit over non-aggressive IV fluid resuscitation in patients with acute pancreatitis, there is insufficient evidence in this meta-analysis to suggest that it increases the mortality. However, this systematic review was limited by the moderate heterogeneity (I² = 36.3%) of the included studies that could lead to selection bias or overtreatment in the aggressive IV fluid resuscitation group. Early aggressive IV fluid resuscitation in patients with acute pancreatitis should be implemented with reassessment of volume status, biochemical and physical fluid responsiveness, rather than relying solely on a fixed model of fluid protocol.



Disclosures:


Thanita Thongtan, MD¹, Asif Zamir, MD, FACG². P1468 - The Effect of Aggressive Intravenous Fluid Resuscitation on the Mortality Outcome in Patients with Acute Pancreatitis: A Systematic Review and Meta-Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.