New Prognostic Markers for Outcome of Acute Pancreatitis

Sigounas, Dimitrios E.; Tatsioni, Athina; Christodoulou, Dimitrios; Tsianos, Epameinondas V.; Ioannidis, John P. A.

doi:10.1097/mpa.0b013e31820bf8ac

Cited by 41 publications

(26 citation statements)

References 57 publications

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“…Moreover, the number of followers has been constantly growing with the research on predictors of severity being arguably the most prolific area in the literature on acute pancreatitis for many years. A recent systematic review of the literature found 184 original studies that reported on 196 different predictors of severity in acute pancreatitis [3]. Strikingly, 144 of 184 (78%) studies reported a statistically significant result for at least one predictor.…”

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confidence: 99%

“…The systematic review mentioned above showed that there was a remarkable heterogeneity between the studies in this regard. The endpoints for the prediction of severity included multiple factor prognostic scores (APACHE II C8 and/or Ranson C3), death, local and/or systemic complications (as defined by the Atlanta symposium), Japanese criteria of severity, organ failure, pancreatic necrosis, infected pancreatic necrosis, length of hospitalisation, ICU admission, and need for surgery [3].…”

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confidence: 99%

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Predicting the Severity of Acute Pancreatitis: Choose the Right Horse Before Hitching the Cart

Petrov

2011

Dig Dis Sci

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confidence: 99%

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confidence: 99%

Predicting the Severity of Acute Pancreatitis: Choose the Right Horse Before Hitching the Cart

Petrov

2011

Dig Dis Sci

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“…With the aim of early prediction of SAP, multiorgan dysfunction syndrome and risk of death, numerous biomarkers have been iteratively studied [18]. The majority of these are inflammatory mediators reflecting the complex pathophysiological pathway of AP.…”

Section: Introductionmentioning

confidence: 99%

Predictive Capacity of Biomarkers for Severe Acute Pancreatitis

Sternby¹,

Hartman

Johansen³

et al. 2016

Eur Surg Res

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Background: Early prediction of severe acute pancreatitis (SAP) substantially improves treatment of patients. A large amount of biomarkers have been studied with this objective. The aim of this work was to study predictive biomarkers using preset cut-off levels in an unselected population of patients with acute pancreatitis (AP). Methods: 232 patients (52.2% males, median age 66 years) with AP admitted to Skåne University Hospital, Malmö, were consecutively enrolled. Blood samples were collected upon admission and clinical data were gathered both prospectively at inclusion and through review of medical notes. Cut-off levels were defined based on the reports of prior studies, and through their results eight biomarkers (IL-1β, IL-6, IL-8, IL-10, TNF-α, MCP-1, procalcitonin and D-dimer) were selected for analysis. Results: Of the patients, 83.2% had mild AP and 16.8% had SAP. Levels of IL-1β, IL-6 and IL-10 were significantly (p < 0.05) higher upon admission in the group with SAP. When applying the preset cut-off levels on our material, sensitivity and specificity for prediction of severity were low. Receiver operating characteristic curves showed that selected cut-off levels were acceptable, but areas under the curves were inferior compared to other studies. The results did not improve when using the revised Atlanta 2012 classification. Conclusions: Previous studies on severity prediction of AP are difficult to compare due to large variations in setups and outcomes. Calculated cut-offs in our cohort were in acceptable range from preset levels, however areas under the curves were low, indicating suboptimal biomarkers for the unselected population investigated. For comparable results and possible clinical implementations, future studies need large consecutive series with a reasonable percentage of severe cases. Additionally, novel biomarkers need to be explored.

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“…The current literature displays a huge number of articles pointing to new potential prognostic markers for outcome of acute pancreatitis, but a recent review of these papers, despite detecting 184 studies developed with this objective, suggests that the reporting on this type of research is suboptimal, not providing enough information to allow the scientific community to come to solid conclusions about their real value [16]. As a consequence, the great majority of these new markers are not incorporated into clinical practice.…”

Section: Diagnosis Of Severe Ap and Of Nhapmentioning

confidence: 99%

Necrotizing Pancreatitis: Update and When to Operate

Refinetti¹,

Martinez²

2012

CMD

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About 20% of the cases of acute pancreatitis present in a severe form, known as necrotizing pancreatitis. Although this entity was first described centuries ago, many questions about it remain open and as a consequence, many studies are currently published addressing this subject nowadays. We performed a throughout research in the literature, with special attention to the articles published in the last five years and indexed to the PubMed. The following headings were used: Pancreatitis, Surgical procedures, Necrosis. The initial research rendered about 1800 articles, and the ones published in the last five years were evaluated. Some older, but remarkable articles were also included given their importance to this matter. As we further describe, treatment of acute pancreatitis involves a great number of questions, among which the most important are the ones related to the terminology of pancreatic collections, prognostic markers, use of antibiotics, type of diet employed and the approach to infected necrosis. Many radical changes could be seen over the last years on all these topics and a constant updating must be necessarily done by the ones involved in the treatment of this disease.

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New Prognostic Markers for Outcome of Acute Pancreatitis

Abstract: Despite some improvements over time, the reporting of important aspects of prognostic studies in acute pancreatitis remains suboptimal. The proposed REMARK-based checklist may help improve the quality and reporting of research in this field.

Cited by 41 publications

References 57 publications

Predicting the Severity of Acute Pancreatitis: Choose the Right Horse Before Hitching the Cart

Predicting the Severity of Acute Pancreatitis: Choose the Right Horse Before Hitching the Cart

Predictive Capacity of Biomarkers for Severe Acute Pancreatitis

Necrotizing Pancreatitis: Update and When to Operate

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