Acute and Chronic Pancreatitis Disease Prevalence, Classification, and Comorbidities: A Cohort Study of the UK BioBank

Spagnolo, Daniel M.; Greer, Phil J.; Ohlsen, Celeste Shelton; Mance, Shannon; Ellison, Mitchell A.; Breze, Cameron R.; Busby, Ben; Whitcomb, David C.; Haupt, Mark

doi:10.14309/ctg.0000000000000455

Cited by 46 publications

(28 citation statements)

References 46 publications

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“…In previous studies in our literature review; biliary etiology was determined in different values such as 53.46%, 60.9%, 22.7%, and 80.9% in AP patients [22][23][24][25]. As seen in the literature, biliary tract pathologies were found to be the most common etiology in our study.…”

Section: Discussionsupporting

confidence: 57%

Does the Percentage of Immature Granulocytes Predict the Severity and Mortality of the Disease in Patients with Acute Pancreatitis Presenting to the Emergency Department?

Kırmızı¹,

Doğan²,

Edizer³

et al. 2022

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Objective: In this study, it was aimed to investigate the percentage of immature granulocytes (IG) and other hemogram parameters in the early period in predicting severe disease, in-hospital and short-term mortality in patients with acute pancreatitis (AP). Materials and Methods:Our study was designed as a retrospective observational clinical study. Patients admitted to the emergency department with the diagnosis of AP between 01.01.2017 and 31.12.2021 years were included in the study. Hemogram parameters were compared according to mortality and the Balthazar severity index. Results:We found that the percentage of IG was not statistically significant for mortality and disease severity. We found that the mean age of the group with mortality was statistically significantly higher than that of the group without mortality (p=0.012). We found that the lymphocyte count was statistically significantly lower in the group with mortality compared to the group without mortality. When we grouped the patients according to the Balthazar severity index, 366 (85.12%) of the patients were evaluated in the mild group, 61 (14.19%) in the moderate group, and 3 (0.69%) in the severe group. Among the groups; we found significant differences in hemoglobin, white blood cell (WBC), neutrophil, length of stay, and Balthazar severity index. Conclusion:The IG percentage does not have a predictive value for the severity of the disease and the mortality process, particularly in patients with mild AP. A decrease in lymphocyte count can be considered a marker for mortality and long-term hospitalization. In patients with AP, WBC count and neutrophil count can be used to predict the severity of the disease on the first admission to the emergency department.

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Section: Discussionsupporting

confidence: 57%

Does the Percentage of Immature Granulocytes Predict the Severity and Mortality of the Disease in Patients with Acute Pancreatitis Presenting to the Emergency Department?

Kırmızı¹,

Doğan²,

Edizer³

et al. 2022

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“…Specialist alcohol services can assist, including managing withdrawal during admission, counselling and selection of patients for medication to reduce dependence [223]. Similar lifestyle advice applies to smoking, which increases the risks of recurrent and chronic pancreatitis [224,225] and pancreas cancer [226].…”

Section: Prevention Of Recurrencementioning

confidence: 99%

Acute Pancreatitis: Diagnosis and Treatment

Szatmary

Grammatikopoulos

Cai

et al. 2022

Drugs

237

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Acute pancreatitis is a common indication for hospital admission, increasing in incidence, including in children, pregnancy and the elderly. Moderately severe acute pancreatitis with fluid and/or necrotic collections causes substantial morbidity, and severe disease with persistent organ failure causes significant mortality. The diagnosis requires two of upper abdominal pain, amylase/lipase ≥ 3 ×upper limit of normal, and/or cross-sectional imaging findings. Gallstones and ethanol predominate while hypertriglyceridaemia and drugs are notable among many causes. Serum triglycerides, full blood count, renal and liver function tests, glucose, calcium, transabdominal ultrasound, and chest imaging are indicated, with abdominal crosssectional imaging if there is diagnostic uncertainty. Subsequent imaging is undertaken to detect complications, for example, if C-reactive protein exceeds 150 mg/L, or rarer aetiologies. Pancreatic intracellular calcium overload, mitochondrial impairment, and inflammatory responses are critical in pathogenesis, targeted in current treatment trials, which are crucially important as there is no internationally licenced drug to treat acute pancreatitis and prevent complications. Initial priorities are intravenous fluid resuscitation, analgesia, and enteral nutrition, and when necessary, critical care and organ support, parenteral nutrition, antibiotics, pancreatic exocrine and endocrine replacement therapy; all may have adverse effects. Patients with local complications should be referred to specialist tertiary centres to guide further management, which may include drainage and/or necrosectomy. The impact of acute pancreatitis can be devastating, so prevention or reduction of the risk of recurrence and progression to chronic pancreatitis with an increased risk of pancreas cancer requires proactive management that should be long term for some patients.

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“…This study provided many new insights, including demonstrating that less than half of CP subjects are very heavy alcohol users ( 15 , 33 , 44 ), and that there were the high rates of CFTR variants in RAP and CP patients ( 45 , 46 ). The presence of risk factors for RAP/CP also differs dramatically between patients in the UK Biobank ( 47 ). These example highlight the importance of comprehensive evaluation of patients and observing the primary and secondary combinations of risk factors that generate pathogenic conditions.…”

Section: Risks Leading To Cp and Opportunities For Interventionsmentioning

confidence: 99%

Central role of the sentinel acute pancreatitis event (SAPE) model in understanding recurrent acute pancreatitis (RAP): Implications for precision medicine

Whitcomb

2022

Front. Pediatr.

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Traditional approaches to understanding the origins of chronic pancreatitis (CP) and find treatments led to abysmal failure. Thus, no drugs now exists to meet this need. Outdated concepts of the etiopathogenesis of CP have been replaced with new insights and disease models that provide the framework for early detection of the pathogenic pancreatitis process. Application of these principals require a new paradigm in disease definition and management, i.e. personalized / precision medicine. The key is acute pancreatitis (AP) starting with the first (sentinel) acute pancreatitis (AP) event (SAPE). This event sensitizes the pancreas to recurrent acute pancreatitis (RAP) as ongoing stressors drive various inflammatory responses to cause CP. The problem is the complex etiologies of AP and the additional genetic and environmental factors that promote progression to RAP and CP. This paper provides a background on the key conceptual changes that facilitate new approaches and the rationale for using mechanism-specific therapies to prevent RAP and CP.

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Acute and Chronic Pancreatitis Disease Prevalence, Classification, and Comorbidities: A Cohort Study of the UK BioBank

Cited by 46 publications

References 46 publications

Does the Percentage of Immature Granulocytes Predict the Severity and Mortality of the Disease in Patients with Acute Pancreatitis Presenting to the Emergency Department?

Does the Percentage of Immature Granulocytes Predict the Severity and Mortality of the Disease in Patients with Acute Pancreatitis Presenting to the Emergency Department?

Acute Pancreatitis: Diagnosis and Treatment

Central role of the sentinel acute pancreatitis event (SAPE) model in understanding recurrent acute pancreatitis (RAP): Implications for precision medicine

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