Predictors for mortality following acute pancreatitis in children

Guo, Qiang; Mao, Li; Chen, Yang; Hu, Hankui; Hu, Weiming

doi:10.1007/s00383-014-3595-6

Cited by 8 publications

(7 citation statements)

References 32 publications

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“…19,23,24 Mortality rate was found 5.7% in a group of children with AP that were hospitalized in pediatric intensive care unit. 25 Guo et al 26 found the mortality rate of 5% in children with AP, and patients with systemic inflammatory response syndrome in the first week of onset, early organ failure, and multiorgan failure in the first week of onset, infected necrosis, and idiopathic cause have higher risk of death.…”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis in children: A single center experience over ten years

et al. 2018

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Acute pancreatitis (AP) is an inflammatory disease characterized by sudden onset abdominal pain together with elevation of pancreatic enzymes and radiographic changes. Increased incidence of AP in children have been reported in recent reports. In this study; we aimed to analyze the demographic characteristics, etiology, outcome and incidence of AP among hospitalized children in our center. Medical records of the children with AP since January 2005 were analyzed from hospital files (N=63). Major etiologies were systemic diseases (14.3%), trauma (11.1%), cholelithiasis (9.5%); 54% (N=34) of the patients had mild AP, while 28.6% (N=18) had moderately severe AP and 17.4% (N=11) had severe AP. Organ dysfunction was found in 11 patients (17.4%) at initial examination. During the follow-up period (68.1±24.3 months), 10 patients (15.9%) experienced 24 recurring AP (RAP) attacks. Male gender, presence of local pancreatic or systemic complications at initial attack, metabolic and hereditary diseases were associated with the increased risk of RAP (p<0.05 for all). The mortality rate associated with AP was 4.84%. There was an increase in the incidence of AP since 2010 (9.57 in 2009-2010 vs. 39.17/10,000 patients in 2015-2016 years; p=0.0002; OR: 4.1) among the hospitalized patients. Our results indicate that AP is a mild disease in children and the incidence is increasing among hospitalized children. Male gender, presence of local pancreatic or systemic complications at initial attack, metabolic diseases and hereditary diseases were associated with the increased risk of RAP.

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Section: Discussionmentioning

confidence: 99%

Acute pancreatitis in children: A single center experience over ten years

et al. 2018

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“…The incidence of acute pancreatitis (AP) in the pediatric population has increased in the last 2 decades (1), ranging from 3.6 to 13.2 cases per 100,000 children (2,3), with a mortality rate between 4% and 10% (4,5).…”

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confidence: 99%

Multivariate Model for the Prediction of Severity of Acute Pancreatitis in Children

Izquierdo¹,

Fonseca

Moreno

et al. 2018

J. pediatr. gastroenterol. nutr.

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This study aimed to develop a severity prediction system for pediatric patients with acute pancreatitis (AP) based on clinical and laboratory parameters recorded at disease onset. A retrospective cohort study including 130 patients with AP, aged 0 to 18 years, was conducted. Correlations between severe AP (SAP) and clinical and laboratory data were established. Parameters with a significant statistical correlation (P ≤ 0.05) were incorporated in logistic regression models, and receiver operating characteristic curves were generated. The best-performance cutoff points were calculated to propose a severity prediction score, for which sensitivity and specificity were determined. Thirty-eight cases (29.2%) were consistent with SAP. A value of ≥1 point yielded a sensitivity of 81.5% and specificity of 64.1% for SAP prediction, when using a score including blood urea nitrogen ≥12.5 mg/dL (1 point) or hemoglobin <13 mg/dL (1 point) as variables. The proposed severity score showed good performance in predicting SAP.

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“…Multiple symptoms may present starting from an early age, including episodic abdominal pain, eruptive cutaneous xanthomata, and hepatosplenomegaly (Feoli-Fonseca et al, 1998). The most severe and life-threatening complication of FCS is acute pancreatitis, which is shown to have a mortality rate of 5-30% in multiple studies (Guo et al, 2014;Gaudet et al, 2016). FCS shows a classic autosomal recessive inheritance pattern, and the prevalence in the United States population is approximately 1 in 1,000,000 (Hegele et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Analysis of a Chinese Pedigree With Familial Chylomicronemia Syndrome Reveals Two Novel LPL Mutations by Whole-Exome Sequencing

et al. 2020

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Familial chylomicronemia syndrome (FCS) is a rare monogenic autosomal recessive disease caused by loss-of-function mutations in genes involved in chylomicron breakdown through hydrolysis of triglycerides into free fatty acids. Patients are often diagnosed in early childhood with extremely high triglyceride levels and symptoms including abdominal pain, eruptive cutaneous xanthomata, hepatosplenomegaly, and significant cognitive, psychological, and social impairment. The most serious medical condition suffered by FCS patients is recurrent acute pancreatitis. Lipoprotein lipase (LPL) gene mutation accounts for majority of the known pathogenic mutations. Early diagnosis and strict low-fat diet are critical for successful management of the triglyceride concentration to lower the risk of pancreatitis. The true prevalence of FCS in China is unknown and here we report a Chinese female preterm neonate presented with an extremely high triglyceride level of 22.11 mmol/L on day 13 after birth. Clinical and laboratory workup including whole-exome sequencing revealed two novel compound heterozygous LPL mutations (c.406G > C and c.829G > C) that are co-segregated with her non-consanguineous parents, consistent with autosomal recessive inheritance. A diagnosis of FCS based on clinical, biochemical, and genetic ground was made to guide her management.

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Predictors for mortality following acute pancreatitis in children

Abstract: Mortality rate and complication rate of acute pancreatitis in children remains low. Patients with SIRS, early organ failure, MOF, infected necrosis, or idiopathic cause should be well evaluated because they have higher risk of death.

Cited by 8 publications

References 32 publications

Acute pancreatitis in children: A single center experience over ten years

Acute pancreatitis in children: A single center experience over ten years

Multivariate Model for the Prediction of Severity of Acute Pancreatitis in Children

Analysis of a Chinese Pedigree With Familial Chylomicronemia Syndrome Reveals Two Novel LPL Mutations by Whole-Exome Sequencing

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