Does Mortality Occur Early or Late in Acute Pancreatitis?

Mutinga, Muthoka L.; Rosenbluth, Adam; Tenner, Scott; Odze, Robert; Sica, Gregory T.; Banks, Peter A.

doi:10.1385/ijgc:28:2:091

Cited by 122 publications

(61 citation statements)

References 27 publications

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“…Wilson et al [17] analyzed 126 deaths from acute pancreatitis; the time to fatal outcome was <7 days in the majority of the patients. In the report by Mutinga et al [6], nearly 50% of the deaths occurred within the first 2 weeks. In contrast, a review of 263 acute pancreatitis cases by Gloor et al [4] found no patients dying within the first 2 weeks after onset of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…It had been suggested that the occurrence of early deaths resulting from multiple organ dysfunction syndrome (MODS) decreased with advanced intensive care [4]. Nevertheless, other studies described that over half of the deaths occurred early and were primarily due to MODS rather than due to infection [5, 6]. Accordingly, it still remains unknown whether the majority of deaths occur early or late.…”

Section: Introductionmentioning

confidence: 99%

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Acute Pancreatitis in the Guangdong Province, China

et al. 2007

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Background/Aims: Many studies have recently been published on acute pancreatitis; however, few large-sample studies have been focused on the risk factors for deaths in severe acute pancreatitis. To address this issue, the present study was intended to assess etiology, severity, and mortality of acute pancreatitis in the Guangdong Province (Guangdong), China, and to analyze the risk factors responsible for deaths in severe acute pancreatitis in this large series of patients. Methods: Four tertiary medical centers located in Guangdong were involved in this retrospective study. Data of 2,342 patients with acute pancreatitis admitted to these centers from December 1990 through December 2005 were collected in a standardized form and analyzed. Results: Of the 2,342 patients (1,130 men and 1,212 women, mean age 51±18, range 4–98 years), 1,778 (76.0%) had mild pancreatitis, and 564 (24.0%) had the severe form. Biliary tract disease (47.5%) was the predominant etiology, the overall mortality rate was 5.0%, and the fatality rate in patients with severe acute pancreatitis was 20.0%. Among the deceased patients in the severe acute pancreatitis group, logistic regression analysis of variables showed that the independent risk factor for mortality was shock, while a biliary origin was a protective factor against a poor prognosis. Conclusions: In this case series, the results suggest that biliary tract disease was the main etiologic factor of acute pancreatitis in Guangdong. The majority of deaths in severe acute pancreatitis occurred within the first 14 days of admission; the only independent risk factor for mortality was systematic complication of shock.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute Pancreatitis in the Guangdong Province, China

et al. 2007

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“…Although older literature suggested that 80% of deaths occur after several weeks of illness as a result of infected necrosis, more recent surveys have shown considerable variation with several reports showing a reasonably even distribution of early deaths (within 1-2 wk) versus later deaths (46,72,76,150,151,163), a few showing the majority of deaths within the first 2 wk (67,75), and others showing the majority of deaths after the first 2 wk (59,89,135). These variations reflect a variety of influences including percentage of very ill patients referred to a reporting hospital compared to patients admitted directly.…”

Section: Overview Of Acute Pancreatitismentioning

confidence: 99%

Practice Guidelines in Acute Pancreatitis

Banks

Freeman

2006

Am J Gastroenterology

1,677

980

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“…16 Geralmente, ocorre devido à síndrome da resposta inflamatória sistêmica e falência orgânica nas primeiras duas semanas e, após esse período, costuma ser decorrente de sepse e suas complicações. 19 O cistoadenoma mucinoso pancreático neoplásico é sugerido após a aferição do marcador tumoral antígeno carcinoembriogênico (CEA) colhido por punção. Valores acima de 110 ng/mL têm sensibilidade de 81% e especificidade de 98% no diagnóstico.…”

Section: Evoluçãounclassified

Estudo clínico-epidemiológico das pancreatites em um hospital de referência terciária entre 2013 e 2014

Lúcio

Borghesi

2016

Rev. Fac. Ciênc. Méd. Sorocaba

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RESUMO Introdução:As manifestações clínicas das pancreatites são tão variadas que se o clínico se ativer somente aos sintomas clássicos, diagnosticará apenas parte dos casos. Método: Estudo descritivo de pacientes diagnosticados com pancreatite aguda e crônica no Conjunto Hospitalar de Sorocaba, São Paulo. Foram revisados 39 prontuários, que cobriram todos os casos de pancreatite de junho de 2013 a junho de 2014. Resultados: Foram 26 casos de pancreatite aguda e 4 de crônica. A etiologia biliar respondeu por 50,0% dos casos, seguida por alcoólica (26,7%) e idiopática (13,3%). A clássica dor em faixa nos quadrantes superiores foi encontrada em 11 pacientes, e em 3 deles foi referida irradiação para o dorso. Diversas outras manifestações dolorosas foram referidas. Quanto à duração, a dor variou de 6 horas a 5 meses. As etiologias encontradas mostraram distribuição diferente entre os gêneros dos pacientes. A duração da dor foi maior entre os casos de pancreatite crônica (mediana: 70,5 versus 2 dias; p=0,02) e os valores da amilase nos casos de pancreatite aguda (mediana: 929 versus 52,5 U/L; p=0,00). Conclusões: A pancreatite aguda e crônica agudizada, quando corretamente diagnosticadas, apresentam evolução benigna, resolvendo-se em poucos dias. A caracterização da dor e das outras manifestações clínicas é pouco esmiuçada nos prontuários, talvez pela relativa facilidade em diagnosticar os casos clássicos e pela disponibilidade de avaliação laboratorial. Palavras-chave: pancreatite; epidemiologia; estudos epidemiológicos; centros de atenção terciária. ABSTRACTIntroduction: Clinical manifestations of pancreatitis are so varied that if the physician only bear the classic symptoms, he will diagnose just part of the cases. Method: This is a descriptive study of patients diagnosed with acute or chronic pancreatitis in the Conjunto Hospitalar de Sorocaba, São Paulo, Brazil. We reviewed 39 medical records, which covered all cases of pancreatitis from June 2013 to June 2014. Results: We found 26 cases of acute pancreatitis and 4 of chronic pancreatatis. Biliary etiology accounted for 50,0% of cases, followed by alcoholic (26.7%) and idiopathic (13.3%). The classic upper abdominal pain was found in 11 patients, and in 3 of them it irradiates to the back. Several other painful manifestations have been reported. The duration of the pain ranged from 6 hours to 5 months. The etiologies found showed different distribution between genders. The duration of pain was higher among cases of chronic pancreatitis (median 70.5 versus 2 days; p=0.02), and the values of amylase were higher in acute pancreatitis (median 929 versus 52.5 U/L; p=0.00). Conclusions: Acute pancreatitis and chronic acutized pancreatitis, when properly diagnosed, have a benign curse, solving in a few days. The characterization of pain and other clinical manifestations are little scrutinized in medical records, perhaps because of the relative ease of classic cases diagnosis and the availability of laboratory tests.

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Does Mortality Occur Early or Late in Acute Pancreatitis?

Cited by 122 publications

References 27 publications

Acute Pancreatitis in the Guangdong Province, China

Acute Pancreatitis in the Guangdong Province, China

Practice Guidelines in Acute Pancreatitis

Estudo clínico-epidemiológico das pancreatites em um hospital de referência terciária entre 2013 e 2014

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