Erratum: Admission Hematocrit and Rise in Blood Urea Nitrogen at 24 h Outperform other Laboratory Markers in Predicting Persistent Organ Failure and Pancreatic Necrosis in Acute Pancreatitis: A Post Hoc Analysis of Three Large Prospective Databases

2016 ◽  
Vol 111 (8) ◽  
pp. 1216 ◽  
Author(s):  
Efstratios Koutroumpakis ◽  
Bechien U Wu ◽  
Olaf J Bakker ◽  
Anwar Dudekula ◽  
Vikesh K Singh ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Blood Urea Nitrogen ◽  
Pancreatic Necrosis ◽  
Urea Nitrogen ◽  
Post Hoc Analysis ◽  
Laboratory Markers ◽  
Persistent Organ Failure ◽  
Post Hoc

scholarly journals Serum Albumin Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Wandong Hong ◽  
Suhan Lin ◽  
Maddalena Zippi ◽  
Wujun Geng ◽  
Simon Stock ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Albumin ◽  
Organ Failure ◽  
Blood Urea Nitrogen ◽  
Serum Albumin Level ◽  
Roc Curves ◽  
Albumin Level ◽  
Urea Nitrogen ◽  
Risk Of Death ◽  
Persistent Organ Failure

Background and Aims. To investigate the association between serum albumin levels within 24 hrs of patient admission and the development of persistent organ failure in acute pancreatitis.Methods. A total of 700 patients with acute pancreatitis were enrolled. Multivariate logistic regression and subgroup analysis determined whether decreased albumin was independently associated with persistent organ failure and mortality. The diagnostic performance of serum albumin was evaluated by the area under Receiver Operating Characteristic (ROC) curves.Results. As levels of serum albumin decrease, the risk of persistent organ failure significantly increases (Ptrend<0.001). The incidence of organ failure was 3.5%, 10.6%, and 41.6% in patients with normal albumin and mild and severe hypoalbuminaemia, respectively. Decreased albumin levels were also proportionally associated with prolonged hospital stay (Ptrend<0.001) and the risk of death (Ptrend<0.001). Multivariate analysis suggested that biliary etiology, chronic concomitant diseases, hematocrit, blood urea nitrogen, and the serum albumin level were independently associated with persistent organ failure. Blood urea nitrogen and the serum albumin level were also independently associated with mortality. The area under ROC curves of albumin for predicting organ failure and mortality were 0.78 and 0.87, respectively.Conclusion. A low serum albumin is independently associated with an increased risk of developing of persistent organ failure and death in acute pancreatitis. It may also be useful for the prediction of the severity of acute pancreatitis.

scholarly journals Hematocrit, Creatinine, and Blood Urea Nitrogen in the Assessment of Pancreatic Necrosis in Acute Pancreatitis: An International Study

2011 ◽  
Vol 140 (5) ◽  
pp. S-12-S-13 ◽  
Author(s):  
Georgios I. Papachristou ◽  
Bechien U. Wu ◽  
Olaf J. Bakker ◽  
Christopher J. Langmead ◽  
Kathryn Repas ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Blood Urea Nitrogen ◽  
Pancreatic Necrosis ◽  
International Study ◽  
Urea Nitrogen

scholarly journals Factors Associated with Fluid Sequestration in Patients with Acute Pancreatitis: A Prospective Study in Tertiary Centre Hospital in Nepal

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Raju Bhandari ◽  
Krishna Sapkota ◽  
Seema Subedi ◽  
Som Kumar Shrestha ◽  
Edward Sutanto ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Mortality ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Linear Regression Analysis ◽  
University Teaching ◽  
Persistent Organ Failure ◽  
Younger Age ◽  
Significant Difference ◽  
The Difference

Background. Acute pancreatitis (AP) is associated with extensive fluid sequestration. The aim of this study was to determine association of fluid sequestration at 48 hours after hospital admission (FS48) in AP patients with demographics, clinical parameters, and outcomes of AP. Methods. A prospective observational study was carried out on all adult patients with AP admitted to Tribhuvan University Teaching Hospital, Nepal, from January to September 2017. FS48 was calculated as the difference between fluid input and output in the first 48 hours of admission. The Kruskal-Wallis test with post hoc Dunn’s test examined the difference in FS48 between mild AP, moderately severe AP, and severe AP. Linear regression analysis was used to evaluate association between FS48 with patients’ characteristics and outcomes of AP. Outcomes of AP assessed included pancreatic necrosis, persistent organ failure, length of stay, and in-hospital mortality. Results. Eighty patients (median age 44 years; 57% male) with a median FS48 of 1610 mL were evaluated. The median FS48 for mild AP, moderately severe AP, and severe AP were 1,180 mL, 2,380 mL, and 3,500 mL, respectively. There was a significant difference in pairwise comparisons between mild AP and moderately severe AP, along with mild AP and severe AP. Younger age, other etiology, and higher creatinine were independently associated with increased FS48. Increased FS48 was significantly associated with pancreatic necrosis, persistent organ failure, and in-hospital mortality. Conclusions. In our study population, younger age and higher creatinine were predictors of increased FS48. Increased FS48 was associated with poorer outcomes of AP.

Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis

Gut ◽  
2018 ◽  
Vol 68 (6) ◽  
pp. 1044-1051 ◽  
Author(s):  
Nicolien J Schepers ◽  
Olaf J Bakker ◽  
Marc G Besselink ◽  
Usama Ahmed Ali ◽  
Thomas L Bollen ◽  
...  
Keyword(s):  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Multiple Organ ◽  
Infected Pancreatic Necrosis ◽  
Disease Course ◽  
Infected Necrosis ◽  
Persistent Organ Failure ◽  
Necrotising Pancreatitis ◽  
Post Hoc ◽  
Prospective Database

ObjectiveIn patients with pancreatitis, early persisting organ failure is believed to be the most important cause of mortality. This study investigates the relation between the timing (onset and duration) of organ failure and mortality and its association with infected pancreatic necrosis in patients with necrotising pancreatitis.DesignWe performed a post hoc analysis of a prospective database of 639 patients with necrotising pancreatitis from 21 hospitals. We evaluated the onset, duration and type of organ failure (ie, respiratory, cardiovascular and renal failure) and its association with mortality and infected pancreatic necrosis.ResultsIn total, 240 of 639 (38%) patients with necrotising pancreatitis developed organ failure. Persistent organ failure (ie, any type or combination) started in the first week in 51% of patients with 42% mortality, in 13% during the second week with 46% mortality and in 36% after the second week with 29% mortality. Mortality in patients with persistent multiple organ failure lasting <1 week, 1–2 weeks, 2–3 weeks or longer than 3 weeks was 43%, 38%, 46% and 52%, respectively (p=0.68). Mortality was higher in patients with organ failure alone than in patients with organ failure and infected pancreatic necrosis (44% vs 29%, p=0.04). However, when excluding patients with very early mortality (within 10 days of admission), patients with organ failure with or without infected pancreatic necrosis had similar mortality rates (28% vs 34%, p=0.33).ConclusionIn patients with necrotising pancreatitis, early persistent organ failure is not associated with increased mortality when compared with persistent organ failure which develops further on during the disease course. Furthermore, no association was found between the duration of organ failure and mortality.

scholarly journals Aggressive Versus Conservative Fluid Treatment for Acute Pancreatitis in Adult Patients: A Meta-Analysis of 3,127 Cases

2021 ◽  
Author(s):  
Jiyang Liao ◽  
Yang Zhan ◽  
Huachu Wu ◽  
Zhijun Yao ◽  
Xian Peng ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Pancreatitis ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Meta Analysis ◽  
Adult Patients ◽  
Cochrane Library ◽  
Persistent Organ Failure

Abstract Background: The advantages of aggressive fluid treatment (AFT) compared to conservative fluid treatment (CFT) within 24 h for acute pancreatitis (AP) remain controversial in adult patients. A meta-analysis was undertaken to investigate whether aggressive strategies are more beneficial.Methods: We searched (on February 1, 2021) PubMed, Embase, and the Cochrane Library for eligible trials that assessed the two therapies and performed a meta-analysis. The primary endpoint was in-hospital mortality. Secondary outcomes were adverse events (e.g., renal failure and pancreatic necrosis) within 24 h of treatment.Results: Five randomized controlled trials (RCTs) and 8 observational studies involving 3,127 patients were identified. There was a significant difference in in-hospital mortality for AFT compared to CFT (OR, 1.66; P = 0.0001). The incidences of renal failure (OR, 2.38; P < 0.00001) and pancreatic necrosis (OR, 2.34; P < 0.0001) were similar and significantly different between the two groups. Patients aged > 50 years had a potentially higher utilization of mechanical ventilation and incidence of respiratory failure (OR, 4.88; P < 0.00001). Persistent organ failure, systemic inflammatory response syndrome (SIRS) and length of hospital stay did not differ significantly between the two groups. Sensitivity analysis identified two significant changes: one in persistent SIRS (OR, 2.37; P = 0.02) in patients aged > 50 years and one in the overall incidence of persistent organ failure (OR, 1.81; P = 0.02).Conclusions: Compared to CFT, AFT increases in-hospital mortality and the incidence of renal failure, pancreatic necrosis and respiratory failure with relatively strong evidence.

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