Pulmonary complications in fatal acute hemorrhagic pancreatitis

Lankisch, P. G.; Rahlf, G; Koop, H.

doi:10.1007/bf01315139

Cited by 65 publications

(15 citation statements)

References 28 publications

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“…These variables had to be recorded during the first 6 h of admission to the hospital to be considered to be present. Standardised definitions were used to identify risk factors (high risk trauma [28,[35][36][37], high-risk surgery [24,[38][39][40], aspiration [28,35,38,41], sepsis [21,35,36,38], shock [21,[42][43][44], pneumonia [21,28,38,45] and pancreatitis [1,21,[46][47][48][49][50]) and risk modifiers (alcohol abuse [24][25][26][27], smoking [24,27], hypoalbuminemia [28,29], tachypnoea [25,28], oxygen supplementation [30], chemotheorapy [25,31] and diabetes mellitus [28,32]). The validation cohort included 467 Olmsted County patients who were admitted to hospital wards (ICU and non-ICU), excluding 1-day surgical procedures, cardiac ob...…”

Section: Predictor Variablesmentioning

confidence: 99%

Acute lung injury prediction score: derivation and validation in a population-based sample

Trillo-Alvarez

Cartin‐Ceba

Kor³

et al. 2010

Eur Respir J

145

129

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Early recognition of patients at high risk of acute lung injury (ALI) is critical for successful enrolment of patients in prevention strategies for this devastating syndrome. We aimed to develop and prospectively validate an ALI prediction score in a population-based sample of patients at risk.In a retrospective derivation cohort, predisposing conditions for ALI were identified at the time of hospital admission. The score was calculated based on the results of logistic regression analysis. Prospective validation was performed in an independent cohort of patients at risk identified at the time of hospital admission.In a derivation cohort of 409 patients with ALI risk factors, the lung injury prediction score discriminated patients who developed ALI from those who did not with an area under the curve (AUC) of 0.84 (95% CI 0.80-0.89; Hosmer-Lemeshow p50.60). The performance was similar in a prospective validation cohort of 463 patients at risk of ALI (AUC 0.84, 95% CI 0.77-0.91; HosmerLemeshow p50.88).ALI prediction scores identify patients at high risk for ALI before intensive care unit admission. If externally validated, this model will serve to define the population of patients at high risk for ALI in whom future mechanistic studies and ALI prevention trials will be conducted.

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Section: Predictor Variablesmentioning

confidence: 99%

Acute lung injury prediction score: derivation and validation in a population-based sample

Trillo-Alvarez

Cartin‐Ceba

Kor³

et al. 2010

Eur Respir J

145

129

View full text Add to dashboard Cite

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“…Predisposing conditions and ALI risk modifiers were identified a priori and were incorporated into the LIPS model predicting ALI development. Predisposing conditions included: high-risk trauma (14-16), high-risk surgery (11,19,29,30), aspiration (11,14,16,31), sepsis (10,11,15,16), shock (10,(32)(33)(34), pneumonia (10,11,14,35), and pancreatitis (10,(36)(37)(38)(39)(40)(41). ALI risk modifiers included: alcohol abuse (18)(19)(20)(21), hypoalbuminemia (14,22), acidosis (14), tachypnea (14,20), oxygen supplementation (23), obesity (25), chemotherapy (20,24), and diabetes mellitus (14,26).…”

Section: Data Collectionmentioning

confidence: 99%

Early Identification of Patients at Risk of Acute Lung Injury

Gajic

Dabbagh

Park

et al. 2011

Am J Respir Crit Care Med

529

316

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Rationale: Accurate, early identification of patients at risk for developing acute lung injury (ALI) provides the opportunity to test and implement secondary prevention strategies. Objectives: To determine the frequency and outcome of ALI development in patients at risk and validate a lung injury prediction score (LIPS). Methods: In this prospective multicenter observational cohort study, predisposing conditions and risk modifiers predictive of ALI development were identified from routine clinical data available during initial evaluation. The discrimination of the model was assessed with area under receiver operating curve (AUC). The risk of death from ALI was determined after adjustment for severity of illness and predisposing conditions. Measurements and Main Results: Twenty-two hospitals enrolled 5,584 patients at risk. ALI developed a median of 2 (interquartile range 1-4) days after initial evaluation in 377 (6.8%; 148 ALI-only, 229 adult respiratory distress syndrome) patients. The frequency of ALI varied according to predisposing conditions (from 3% in pancreatitis to 26% after smoke inhalation). LIPS discriminated patients who developed ALI from those who did not with an AUC of 0.80 (95% confidence interval, 0.78-0.82). When adjusted for severity of illness and predisposing conditions, development of ALI increased the risk of in-hospital death (odds ratio, 4.1; 95% confidence interval, 2.9-5.7). Conclusions: ALI occurrence varies according to predisposing conditions and carries an independently poor prognosis. Using routinely available clinical data, LIPS identifies patients at high risk for ALI early in the course of their illness. This model will alert clinicians about the risk of ALI and facilitate testing and implementation of ALI prevention strategies. Clinical trial registered with www.clinicaltrials.gov (NCT00889772).

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“…The prevalence of pulmonary complications in autopsy studies ranges from 20% to 100%, pulmonary oedema being the most common finding. 4,5,8,9 The Clinical manifestations of acute pancreatitis are so varied that it should be considered in the differential diagnosis of all cases of upper abdominal pain. 10 Cases of sudden death due to acute pancreatitis have been reported in the past where diagnosis could not be made until autopsy.…”

Section: Discussionmentioning

confidence: 99%