Early prediction of organ failure under the revised Atlanta classification

Liu, Jian; Cao, Feng; Dong, Xiao; Li, Peng yu; Li, Hai chao; Qi, Bao; li, Fei

doi:10.5152/tjg.2016.0378

Cited by 7 publications

(6 citation statements)

References 26 publications

(60 reference statements)

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“…When base excess < -3.0 mmol/L, the risk of adverse outcomes increase. 21,[31][32][33] In our study, we found that BE lower than −5.2 may be an independent factor for the early prediction of adverse outcomes in AP patients.…”

supporting

confidence: 52%

“…Previous studies have shown that some laboratory indicators such as PH, base excess (BE), calcium, hematocrit (HCT), lactic acid (Lac) are helpful indicators of severity and prognosis in AP and can be used for the early selection of appropriate treatment. [16][17][18][19][20][21][22] These laboratory indicators can be quickly known by a bedside arterial blood gas analyzer (ABG). Therefore, we tried to develop a rapid prognosis scoring system based on ABG to predict the adverse outcomes in patients with acute pancreatitis in the emergency department.…”

Section: Introductionmentioning

confidence: 99%

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A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department

Lai¹,

Wei²,

Cheng³

et al. 2022

JIR

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Objective To establish a rapid and concise prognosis scoring system for pancreatitis in the emergency department based on bedside arterial blood gas analysis (ABG). Methods A single-center, retrospective cohort study was used to establish the new scoring system, and a validation group was used to verify it. The primary endpoint was 60-day death, and secondary endpoints were 28-day death, admission to the intensive care unit (AICU), requirement for mechanical ventilation (MV) and persistent organ failure (POF). Receiver operating characteristic (ROC) curves was drawn to validate the predictive value of the new scoring system. The performance of the new scoring system was compared with that of conventional predictive scoring. Results 443 patients were in the derivation group and 217 patients in the validation group, of which 27 and 25 died during follow-up. A total of 443 patients in the derivation group, 27 of whom died during the follow-up period. Multivariate regression analysis showed that mental status, hematocrit (HCT), base excess (BE) and Serum ionic calcium (Ca 2+ ) were independent risk factors for 60-day mortality of pancreatitis, and they were used to create a new scoring system (MHBC). In the derivation and validation, the ability of MHBC (AUC= 0.922, 0.773, respectively) to predict 60-day mortality from pancreatitis was no less than that of APACHE II (AUC= 0.838, 0.748, respectively) and BISAP (AUC= 0.791, 0.750, respectively), while, MHBC is more quickly and concisely than APACHE II and BISAP. Compared with MHBC less than or equal to 2, when MHBC is greater than 2, the 28-day mortality, 60-day mortality and the incidence of AICU, MV and POF increased significantly ( P <0.001). Conclusion The MHBC can quickly and concisely evaluate the 60-day mortality, 28-day mortality, and the incidence of AICU, MV and POF of patients with acute pancreatitis in the emergency department.

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supporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department

Lai¹,

Wei²,

Cheng³

et al. 2022

JIR

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“…Although HTG-AP and AAP exhibited the most severe forms of AP from an aetiologic point of view, the data of POF does not support it. This can be explained by the fact that POF associated with AP was assessed in HTG-AP patients only in three of the articles included in our meta-analysis 38,77,90 . In the study of Wang et al 148 POF was most commonly observed in HTG-AP, which is in accordance with our results for severity.…”

Section: Discussionmentioning

confidence: 98%

Assessment of the course of acute pancreatitis in the light of aetiology: a systematic review and meta-analysis

Bálint

Für

Kiss

et al. 2020

Sci Rep

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The main causes of acute pancreatitis (AP) are biliary disease, alcohol consumption, hypertriglyceridaemia (HTG) and endoscopic retrograde cholangiopancreatography (ERCP). The aim of this meta-analysis was to evaluate the effects of these aetiological factors on the severity and outcome of AP. Pubmed and Embase were searched between 01/01/2012 and 31/05/2020. Included articles involved adult alcoholic, biliary, HTG- or post-ERCP AP (PAP) patients. Primary outcome was severity, secondary outcomes were organ failures, intensive care unit admission, recurrence rate, pancreatic necrosis, mortality, length of hospital stay, pseudocyst, fluid collection and systematic inflammatory response syndrome. Data were analysed from 127 eligible studies. The risk for non-mild (moderately severe and severe) condition was the highest in HTG-induced AP (HTG-AP) followed by alcoholic AP (AAP), biliary AP (BAP) and PAP. Recurrence rate was significantly lower among BAP vs. HTG-AP or AAP patients (OR = 2.69 and 2.98, 95% CI 1.55–4.65 and 2.22–4.01, respectively). Mortality rate was significantly greater in HTG-AP vs. AAP or BAP (OR = 1.72 and 1.50, 95% CI 1.04–2.84 and 0.96–2.35, respectively), pancreatic necrosis occurred more frequently in AAP than BAP patients (OR = 1.58, 95% CI 1.08–2.30). Overall, there is a potential association between aetiology and the development and course of AP. HTG-AP is associated with the highest number of complications. Furthermore, AAP is likely to be more severe than BAP or PAP. Greater emphasis should be placed on determining aetiology on admission.

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“…Other studies that did not apply these concepts and/or recommendations to categorize patients' severity were subdivided as follows: studies that just compared the efficiency of prognostic markers (chemical / biological / clinical parameter) and of old rating scores to the new concepts used to determine the severity of patients, which were disclosed after the Atlanta classification revision (TABLE 2) (6)(7)(8)(9)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98)(99)(100) ; and studies that just evaluated and validated the recommendations issued after the Atlanta Classification revision (TABLE 3) (11,(101)(102)(103)(104)(105)(106)(107)(108)(109)(110) .…”

Section: Resultsmentioning

confidence: 99%

“…Adopted Atlanta Revision Criteria Nationality Koziel D (88) 2015 822 Severity Classification Canada Liu J (89) 2016 214 Severity Classification China Guo Q (6) 2015 973 Severity Classification China Chen Y (7) 2015 395 Severity Classification China He WH (90) 2017 708 Severity Classification China Zhang J (91) 2014 155 Severity Classification China Xiao Don (92) 2015 573 Severity Classification / Pancreatic Necrosis China Yang Z (93) 2015 1308 Severity Classification China Lee KJ (94) 2016 146 Severity Classification South Korea Zubia OF (95) 2016 374 Severity Classification Spain Acevedo N (96) 2014 459 Severity Classification Spain Kadiyala V (8) 2016 338 Severity Classification USA Nawaz H (97) 2013 256 Severity Classification USA Jones MJ (98) 2017 629 Severity Classification United Kingdom Bansal SS (9) 2016 228 Severity Classification United Kingdom Ikeura T (99) 2016 1159 Severity Classification Japan Gravito S (100) 2018 312 Severity Classification / Diagnosis Portugal TABLE 3. Studies that just evaluated and validated the recommendations and concepts presented after the Atlanta Classification revision.…”

Section: Author Publication Year Number Of Participantsmentioning

confidence: 99%

The Acceptance of Changes in the Management of Patients With Acute Pancreatitis After the Revised Atlanta Classification

Alves

Ferrazza

Nunes

et al. 2021

Arq. Gastroenterol.

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BACKGROUND: New recommendations for the management of patients with acute pancreatitis were set after the Atlanta Classification was revised in 2012. OBJECTIVE: The aim of the present systematic review is to assess whether these recommendations have already been accepted and implemented in daily medical practices. METHODS: A systematic literature review was carried out in studies conducted with humans and published in English and Portuguese language from 10/25/2012 to 11/30/2018. The search was conducted in databases such as PubMed/Medline, Cochrane and SciELO, based on the following descriptors/Boolean operator: “Acute pancreatitis” AND “Atlanta”. Only Randomized Clinical Trials comprising some recommendations released after the revised Atlanta Classification in 2012 were included in the study. RESULTS: Eighty-nine studies were selected and considered valid after inclusion, exclusion and qualitative evaluation criteria application. These studies were stratified as to whether, or not, they applied the recommendations suggested after the Atlanta Classification revision. Based on the results, 68.5% of the studies applied the recommendations, with emphasis on the application of severity classification (mild, moderately severe, severe); 16.4% of them were North-American and 14.7% were Chinese. The remaining 31.5% just focused on comparing or validating the severity classification. CONCLUSION: Few studies have disclosed any form of acceptance or practice of these recommendations, despite the US and Chinese efforts. The lack of incorporation of these recommendations didn’t enable harnessing the benefits of their application in the clinical practice (particularly the improvement of the communication among health professionals and directly association with the worst prognoses); thus, it is necessary mobilizing the international medical community in order to change this scenario.

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Early prediction of organ failure under the revised Atlanta classification

Cited by 7 publications

References 26 publications

A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department

A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department

Assessment of the course of acute pancreatitis in the light of aetiology: a systematic review and meta-analysis

The Acceptance of Changes in the Management of Patients With Acute Pancreatitis After the Revised Atlanta Classification

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