Lessons Learnt From the Management of Severe Acute Pancreatitis in the Critical Care Unit

Patel, Gaural; Rasheed, Ashraf

doi:10.14309/00000434-201510001-00071

Cited by 1 publication

(2 citation statements)

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“…In three of these studies, the risk of death for patients with MSAP was 0%19 24 36 compared with 21%–40%19 24 for patients with SAP. A similar pattern regarding SAP mortality was found across the other 14 studies,18 22 23 25–35 with the risk ranging from 13.6%27 to 41.9%27; EU-5 estimates on mortality were higher for SAP than US estimates (41.9%) 27. However, the available EU-5 estimates on SAP mortality need to be viewed with caution because of the lack of reported information to allow reclassification of patients according to the RAC 2012 criteria.…”

Section: Resultssupporting

confidence: 80%

“…Six18–24 (reported in seven publications) of the 19 included studies were US based. Of the 13 EU-5 studies, five3 25–28 were conducted in the UK, three each in Germany29–31 and Italy,32–34 and one each in France35 and Spain 36. Overall, most studies were of a retrospective design (13 studies),3 21–23 25–33 were based on single-centre hospitals (13)18–22 24–26 28 29 31 33 35 36 and were principally tertiary referral units for which the reporting was exclusively on patients with SAP (10) 22 23 25–31 33.…”

Section: Resultsmentioning

confidence: 99%

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Moderately severe and severe acute pancreatitis : a systematic review of the outcomes in the USA and European Union-5

Sarri¹,

Guo²,

Iheanacho³

et al. 2019

BMJ Open Gastroenterol

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Background and objectivesThe global incidence of hospitalisation due to acute pancreatitis (AP) has been rising in the recent decades. In the USA alone, there was a 13.2% increase between 2009 and 2012 compared with 2002–2005. There remains a lack of approved treatments to prevent disease progression, leaving many liable to developing complications that include multisystem organ failure (OF) and death. This therapeutic deficit raises questions about the scale of the current burden of illness (BOI) associated with severe forms of AP. The aim of the systematic literature review (SLR) was to assess clinical, humanistic, and economic outcomes associated with moderately severe AP (MSAP) and severe AP (SAP) in the USA and the European Union-5 (EU-5).MethodsSystematic searches were conducted in MEDLINE and Embase to identify studies published in English (between 2007 and 2017) that reported on the BOI of MSAP and/or SAP. Manual searches of ‘grey’ literature sources were also conducted.ResultsThe SLR identified 19 studies which indicated that 15%–20% of patients with AP progress to more severe forms of the disease, up to 10.5% of those with SAP require surgery for complications, and up to 40% die during hospitalisation. By contrast, there appears to be a lack of data on the extent to which SAP affects patients’ quality of life.ConclusionThe available evidence clearly demonstrates that the current management for MSAP and SAP in the USA and EU-5 does not adequately meet patients’ needs. Early identification and intervention for AP is crucial, given the evidence of high rates of morbidity and an associated economic burden that is considerable. Since many patients with the condition present to hospitals at a point when multisystem OF or death is highly likely, there is a particularly urgent need for effective treatment options to prevent disease progression.

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