Etiology and mortality in severe acute pancreatitis: A multicenter study in Japan

Yasuda, Hideto; Horibe, Masayasu; Sanui, Masamitsu; Sasaki, Mitsuhito; Suzuki, Naoya; Sawano, Hirotaka; Goto, Takashi; Ikeura, Tsukasa; Takeda, Tsuyoshi; Oda, Takuya; Ogura, Yuki; Miyazaki, Dai; Kitamura, Katsuya; Chiba, Nobutaka; Ozaki, Tetsu; Yamashita, Takahiro; Koinuma, Toshitaka; Oshima, Taku; Yamamoto, Tomonori; Hirota, Morihisa; Sato, Mizuki; Kyo, Michihito; Mine, Tetsuya; Misumi, Takuyo; Takeda, Yoshihiko; Iwasaki, Eisuke; Kanai, Takanori; Mayumi, Toshihiko

doi:10.1016/j.pan.2020.03.001

Cited by 33 publications

(24 citation statements)

References 28 publications

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“…Acute pancreatitis (AP) is an inflammatory disorder of the pancreas and is associated with substantial morbidity and mortality. 1 The Revised Atlanta Classification of 2012 proposed new classification criteria for AP. According to these criteria, AP can be divided into three types: mild AP (MAP) with no organ failure (OF), moderately severe AP (MSAP) with OF lasting ≤ 48 h, and severe AP (SAP) with persistent OF (POF) lasting > 48 h. 2 Extensive research over the last few decades has demonstrated that the first 24 h after symptom onset in AP are critical for identifying patients who are at risk of developing complications or death.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Novel Prognostic Score Based on Thrombotic and Inflammatory Biomarkers for Predicting 28-Day Adverse Outcomes in Patients with Acute Pancreatitis

Han¹,

Cheng²,

Liao³

et al. 2022

JIR

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Background Acute pancreatitis (AP) is a multifactorial disease that is associated with substantial morbidity and mortality. Thrombosis and inflammation are involved in the development and progression of AP. Aim To develop and validate a novel and simple scoring system for predicting 28-day adverse outcomes in AP patients based on a thrombotic and an inflammatory biomarker. Methods A single-center, retrospective cohort study was used to establish the new scoring system (thrombo-inflammatory prognostic score; TIPS), and another study was used to verify it. The study end points were 28-day mortality, requirement for mechanical ventilation (MV), persistent organ failure (POF), and admission to the intensive care unit (AICU). Receiver operating characteristic (ROC) curves was drawn to validate the predictive value of the TIPS. The performance of the TIPS was compared with that of conventional predictive scoring systems. Logistic regression models were used to investigate the relationship between the TIPS and the different end points. Results Among 440 patients with AP in the derivation group, 27 patients died within the 28-day follow-up period. Prothrombin time (PT) and interleukin-6 (IL-6) were used to calculate the TIPS. The TIPS (AUC=0.843) showed a performance comparable to that of the more established APACHE II (AUC=0.841), SOFA (AUC=0.797), BISAP (AUC=0.762), and Balthazar CT (AUC=0.655) in predicting 28-day mortality in AP. The 28-day mortality and the incidence of MV, POF, and AICU were significantly higher among patients with a higher TIPS ( P <0.001). The results of logistic regression analyses indicated that the TIPS was independently associated with the risks of 28-day mortality, AICU, MV and POF. Conclusion The TIPS can enable prediction of 28-day adverse clinical outcomes with AP patients in the ED.

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Section: Introductionmentioning

confidence: 99%

Development and Validation of a Novel Prognostic Score Based on Thrombotic and Inflammatory Biomarkers for Predicting 28-Day Adverse Outcomes in Patients with Acute Pancreatitis

Han¹,

Cheng²,

Liao³

et al. 2022

JIR

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“…However, in this study, we didn't nd any difference in HDL level between the POF and the TOF groups, which could be due to the different etiological characteristics of AP in the general populationand APIP. The etiology of AP in the general population is mainly biliary type [34,35], while APIP is mainly HTG type [1]. The changes of lipid metabolism in the latter may be different from that in biliary type AP.…”

Section: Discussionmentioning

confidence: 99%

Nomogram for Predicting Persistent Organ Failure with Acute Pancreatitis in Pregnancy

Sheng

Wang

2022

Preprint

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Background: Acute pancreatitis in pregnancy (APIP) with persistent organ failure (POF) poses a high risk of death for mother and fetus. This study sought to create a nomogram model for early prediction of POF with APIP patients.Methods: We conducted a cross-sectional study on APIP patients with organ failure (OF) between January 2012 and March 2021 in a university hospital. 131 patients were collected. Their clinical courses and pregnancy outcomes were obtained. Risk factors for POF were identified by univariate and multivariate logistic regression analysis. Prediction models with POF were built and nomogram was plotted. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots.Results: Hypertriglyceridemia was the most common etiology in this group of APIP patients, which accounted for 50% of transient organ failure (TOF) and 72.3% of POF. All in-hospital maternal death was in the POF group (P<0.05), which also had a significantly higher perinatal mortality rate than the TOF group (P<0.05). Univariate and multivariate logistic regression analysis determined that lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were independent risk factors for predicting POF in APIP. A nomogram for POF was created by using the four indicators. The area under the curve was 0.875 (95% confidence interval 0.80–0.95). The nomogram had a bootstrapped-concordance index of 0.85 and was well-calibrated.Conclusions: Hypertriglyceridemia was the leading cause of organ failure-related APIP. Lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were the independent risk factors of POF in APIP. Our nomogram model showed an effective prediction of POF with the four indicators in APIP patients.

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“…Among studies conducted with AP patients before the pandemic, the study by Karaali et al with 343 AP patients established a mortality rate of 4.7% and reported the rate of severe AP as 19.2% [ 28 ]. The multicenter study by Yasuda et al on AP patients found a 30-day mortality rate of 5.4% in 1097 patients [ 29 ]. Likewise, the multicenter study by Matta et al reviewing data from 22 countries reported a mortality rate of 5.7% in Europe, 3.3% in India, 2.3% in Latin America and 0.6% in North America.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the effect of SARS-Cov-2 infection on prognosis and mortality in patients with acute pancreatitis

Karaali

Topal

2021

The American Journal of Emergency Medicine

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Introduction Acute pancreatitis (AP) is the leading cause of hospitalization among gastrointestinal disorders. The aim of our study is to compare the results between AP patients with and without COVID−19, and to reveal the effects of COVID−19 on the course, intensive care needs and mortality of AP patients. Material methods This was a single-center, retrospective and observational study. Patients over 18 years of age, who were diagnosed with AP during the current pandemic. According to the RT-PCR test result, patients were divided into two groups: COVID-19 positive and COVID-19 negative. Gender, age, laboratory parameters, intensive care unit admission, length of hospital stay, severity and mortality of AP were compared between these two groups. Results We reviewed 562 patients presenting to the emergency department who were diagnosed with acute pancreatitis between 10.03.2020 and 31.12.2020 and included 189 patients in our study. Positive patients need for intensive care (7.23%) were higher compared to negative patients (0.94%). 32.53% of positive patients and 14.15% of negative patients had severe AP ( p < 0.03). We established that being COVID-19 positive, CCI scores of ≥5, presence of COVID-19 compatible pneumonia on CT and BISAP scores had an effect on mortality ( p < 0,05). Conclusion The severity and mortality of AP increase in patients with both AP and COVID-19. This rate increases even more in the presence of COVID-19-associated pneumonia. We believe that new strategies should be developed for the follow-up and treatment of patients with both these conditions.

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Etiology and mortality in severe acute pancreatitis: A multicenter study in Japan

Cited by 33 publications

References 28 publications

Development and Validation of a Novel Prognostic Score Based on Thrombotic and Inflammatory Biomarkers for Predicting 28-Day Adverse Outcomes in Patients with Acute Pancreatitis

Development and Validation of a Novel Prognostic Score Based on Thrombotic and Inflammatory Biomarkers for Predicting 28-Day Adverse Outcomes in Patients with Acute Pancreatitis

Nomogram for Predicting Persistent Organ Failure with Acute Pancreatitis in Pregnancy

Evaluating the effect of SARS-Cov-2 infection on prognosis and mortality in patients with acute pancreatitis

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