scholarly journals Serum Triglyceride Level: A Predictor of Complications and Outcomes in Acute Pancreatitis?

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Hassan Tariq ◽  
Vinaya Gaduputi ◽  
Richard Peralta ◽  
Naeem Abbas ◽  
Suresh Kumar Nayudu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Length Of Stay ◽  
Triglyceride Level ◽  
Independent Predictor ◽  
Serum Triglyceride ◽  
Hospital Length Of Stay ◽  
Serum Triglyceride Level ◽  
Systemic Complications

Aim.To study serum triglyceride level as a predictor of complications and outcomes in acute pancreatitis.Methods.In this retrospective observational study, 582 patients admitted with acute pancreatitis, who had serum triglyceride levels measured within the first 24 hours, were divided into two groups. The study group consisted of patients with a triglyceride level ≥2.26 mmol/L (group 2) and the control group consisted of triglyceride level of <2.26 mmol/L (group 1). We collected data for baseline demographics, laboratory values, incidence of complications (local and systemic), admission to the intensive care unit (ICU), ICU length of stay, length of total hospital stay, and death in the two groups.Results.A triglyceride level of ≥2.26 mmol/L was found to be an independent predictor of developing altered mental status (p: 0.004), pancreatic necrosis (p: 0.001), acute respiratory distress syndrome (p: 0001), systemic Inflammatory response syndrome (p: 0.001), acute kidney injury (p: 0.001), hospital length of stay (LOS) (p: 0.002), admission to intensive care unit (ICU) (p: 0.002), and ICU LOS (p: 0.003).Conclusion.A triglyceride level of ≥2.26 mmol/L on admission in acute pancreatitis is an independent predictor of developing local and systemic complications, hospital LOS, admission to ICU, and ICU LOS.

scholarly journals Comparison of clinical characteristics and outcomes between alcohol-induced and gallstone-induced acute pancreatitis: An Australian retrospective observational study

2021 ◽  
Vol 9 ◽  
pp. 205031212110308
Author(s):  
Santiago Cegarra Garcia ◽  
Michael Toolis ◽  
Max Ubels ◽  
Taha Mollah ◽  
Eldho Paul ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Intensive Care Unit Mortality ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Index Of Severity

Objectives: To compare the characteristics and outcomes of patients presenting to hospital with alcohol-induced and gallstone-induced acute pancreatitis. Methods: Retrospective study of all patients with alcohol-induced or gallstone-induced pancreatitis during the period 1 June 2012 to 31 May 2016. The primary outcome measure was hospital mortality. Secondary outcome measures included hospital length of stay, requirements for intensive care unit admission, intensive care unit mortality, mechanical ventilation, renal replacement therapy, requirement of inotropes and total parenteral nutrition. Results: A total of 642 consecutive patients (49% alcohol; 51% gallstone) were included. No statistically significant differences were found between alcohol-induced and gallstone-induced acute pancreatitis with respect to hospital mortality, requirement for intensive care unit admission, intensive care unit mortality and requirement for mechanical ventilation, renal replacement therapy, inotropes or total parenteral nutrition. There was significant difference in hospital length of stay (3.07 versus 4.84; p  < 0.0001). On multivariable regression analysis, Bedside Index of Severity in Acute Pancreatitis score (estimate: 0.393; standard error: 0.058; p < 0.0001) and admission haematocrit (estimate: 0.025; standard error: 0.008; p = 0.002) were found to be independently associated with prolonged hospital length of stay. Conclusion: Hospital mortality did not differ between patients with alcohol-induced and gallstone-induced acute pancreatitis. The duration of hospital stay was longer with gallstone-induced pancreatitis. Bedside Index of Severity in Acute Pancreatitis score and admission haematocrit were independently associated with hospital length of stay.

scholarly journals The clinical traits of acute pancreatitis in aging patients: a retrospective analysis of 473 cases

2020 ◽  
Author(s):  
Nonghua Lu ◽  
Bingjun Yu ◽  
Fengwen Xie
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Abdominal Pain ◽  
Length Of Stay ◽  
Organ Failure ◽  
Death Rate ◽  
Hospital Length ◽  
Hospital Length Of Stay

Abstract Background The incidence of acute pancreatitis in aging patients has increasing in recent years. Controversial results about clinical outcomes of acute pancreatitis in aging patients were reported in different literature. The aim of our study was to compare the clinical outcomes of AP in aging patients between 60-79 years old and over 80 years old. Methods 80 patients aged ≥ 80 years old(oldest group) were compared to 393 patients aged 60 to 79 years old(older group). The clinical course, biochemical, radiological data were enrolled. The primary endpoint was to compare the death rate, intensive care unit admission rate and in-hospital length of stay(LOS). The secondary endpoint was operative treatment and the complications of AP. Results Abdominal symptom of abdominal pain (61.3% vs 46.3%, P=0.013) was less in oldest group, while diarrhea(18.3% vs 30.0%, P=0.018), jaundice(8.9% vs 17.5%, P=0.021), dyspnea(11.5% vs 26.3%, P=0.001) were more obvious in older group than oldest group. A higher death rate (8.9% vs 16.3%, P = 0.003) and longer hospital length of stay (11.51±10.19 vs 15.26±11.04, P = 0.001) were found in aging patients aged ≥80 years old. Mean BMI was lower in oldest group compared to older group(22.36±2.89 vs 21.07±3.18, P = 0.001). Multivariate analysis identified aged over 80 years(OR 3.299, 95%CI 1.316-8.269, P=0.011) and organ failure(P<0.05) as independent risk factors of mortality. More severe of AP(OR 11.722, 95%CI 4.780-28.764, P=0.001), abdominal pain(OR 1.906, 95%CI 1.052-3.453, P=0.033) and organ failure(P<0.05) were recognized as influencing intensive care unit rate. Aging patients aged over 80 years old(OR 0.149, 95%CI 2.027-6.268, P=0.001), more severe of AP(OR 0.218, 95%CI 1.567-4.322, P=0.001), female(OR 0.093, 95%CI 0.336-3.542, P=0.018), Jaundice(OR 0.080, 95%CI 0.146-5.324, P=0.038), operative treatment(P<0.05) and organ failure(P<0.05) were the risk factors for LOS.

scholarly journals Elevated Serum Triglyceride Level as a Predictor of Local and Systemic Complications in Acute Pancreatitis

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S887-S888
Author(s):  
N.J. Hidalgo ◽  
E. Pando ◽  
P. Alberti ◽  
M.J. Gómez ◽  
R. Mata ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Triglyceride Level ◽  
Elevated Serum ◽  
Serum Triglyceride ◽  
Serum Triglyceride Level ◽  
Systemic Complications ◽  
Local And Systemic Complications

scholarly journals Postoperative delirium after cardiac surgery of elderly patients as an independent risk factor for prolonged length of stay in intensive care unit and in hospital

2021 ◽  
Author(s):  
Andrea Kirfel ◽  
Jan Menzenbach ◽  
Vera Guttenthaler ◽  
Johanna Feggeler ◽  
Andreas Mayr ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Hospital Length Of Stay ◽  
Confusion Assessment

Abstract Background Postoperative delirium (POD) is a relevant and underdiagnosed complication after cardiac surgery that is associated with increased intensive care unit (ICU) and hospital length of stay (LOS). The aim of this subgroup study was to compare the frequency of tested POD versus the coded International Statistical Classification of Diseases and Related Health Problems (ICD) diagnosis of POD and to evaluate the influence of POD on LOS in ICU and hospital. Methods 254 elective cardiac surgery patients (mean age, 70.5 ± 6.4 years) at the University Hospital Bonn between September 2018 and October 2019 were evaluated. The endpoint tested POD was considered positive, if one of the tests Confusion Assessment Method for ICU (CAM-ICU) or Confusion Assessment Method (CAM), 4 'A's Test (4AT) or Delirium Observation Scale (DOS) was positive on one day. Results POD occurred in 127 patients (50.0%). LOS in ICU and hospital were significantly different based on presence (ICU 165.0 ± 362.7 h; Hospital 26.5 ± 26.1 days) or absence (ICU 64.5 ± 79.4 h; Hospital 14.6 ± 6.7 days) of POD (p < 0.001). The multiple linear regression showed POD as an independent predictor for a prolonged LOS in ICU (48%; 95%CI 31–67%) and in hospital (64%; 95%CI 27–110%) (p < 0.001). The frequency of POD in the study participants that was coded with the ICD F05.0 and F05.8 by hospital staff was considerably lower than tests revealed by the study personnel. Conclusion Approximately 50% of elderly patients who underwent cardiac surgery developed POD, which is associated with an increased ICU and hospital LOS. Furthermore, POD is highly underdiagnosed in clinical routine.

Ketamine as an Analgesic Adjuvant in Adult Trauma Intensive Care Unit Patients With Rib Fracture

2018 ◽  
Vol 52 (9) ◽  
pp. 849-854 ◽  
Author(s):  
Mary K. Walters ◽  
Joseph Farhat ◽  
James Bischoff ◽  
Mary Foss ◽  
Cory Evans
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Group Versus ◽  
Standard Of Care ◽  
Pain Scale ◽  
Rib Fracture ◽  
Hospital Length Of Stay ◽  
Control Group ◽  
Opioid Use

Background: Rib fracture associated pain is difficult to control. There are no published studies that use ketamine as a therapeutic modality to reduce the amount of opioid to control rib fracture pain. Objective: To examine the analgesic effects of adjuvant ketamine on pain scale scores in trauma intensive care unit (ICU) rib fracture. Methods: This retrospective, case-control cohort chart review evaluated ICU adult patients with a diagnosis of ≥1 rib fracture and an Injury Severity Score >15 during 2016. Patients received standard-of-care pain management with the physician’s choice analgesics with or without ketamine as a continuous, fixed, intravenous infusion at 0.1 mg/kg/h. Results: A total of 15 ketamine treatment patients were matched with 15 control standard-of-care patients. Efficacy was measured via Numeric Pain Scale (NPS)/Behavioral Pain Scale (BPS) scores, opioid use, and ICU and hospital length of stay. Safety of ketamine was measured by changes in vital signs, adverse effects, and mortality. Average NPS/BPS, severest NPS/BPS, and opioid use were lower in the ketamine group than in controls (NPS: 4.1 vs 5.8, P < 0.001; severest NPS: 7.0 vs 8.9, P = 0.004; opioid use: 2.5 vs 3.5 mg morphine equivalents/h/d, P = 0.015). No difference was found between the cohort’s length of stay or mortality. Average diastolic blood pressure was higher in the treatment group versus the control group (75.3 vs 64.6 mm Hg, P = 0.014). Conclusion: Low-dose ketamine appears to be a safe and effective adjuvant option to reduce pain and decrease opioid use in rib fracture.

Hospital Length of Stay Among Patients Receiving Intermittent Versus Prolonged Piperacillin/Tazobactam Infusion in the Intensive Care Units

2017 ◽  
Vol 33 (2) ◽  
pp. 134-141 ◽  
Author(s):  
Jeannie D. Chan ◽  
Timothy H. Dellit ◽  
John B. Lynch
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Randomized Trials ◽  
Average Duration ◽  
Intermittent Infusion ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Inclusion Criteria ◽  
Prolonged Infusion

Objectives: We sought to evaluate clinical outcomes of intensive care unit (ICU) patients following a hospital-wide initiative of prolonged piperacillin/tazobactam (PIP/TAZ) infusion. Methods: Retrospective observational study of patients >18 years old who was hospitalized in the ICU receiving PIP/TAZ for >72 hours during the preimplementation (June 1, 2010 to May 31, 2011) and postimplementation (July 7, 2011 to June 30, 2014) periods. Results: There were 124 and 429 patients who met inclusion criteria with average age of 54.3 and 56.9 years, and average duration of PIP/TAZ therapy was 6.1 ± 2.8 days and 5.9 ± 3.4 days in the pre- and postimplementation period, respectively. Intensive care unit and hospital length of stay (LOS) following initiation of PIP/TAZ were 8.0 ± 8.4 days versus 6.4 ± 6.8 days and 26.3 ± 22.8 days versus 20.4 ± 16.1 days among patients in the pre- and postimplementation periods, respectively. Compared to patients who received intermittent PIP/TAZ infusion, the adjusted difference in ICU and hospital LOS was 0.6 ± 0.8 days (95% confidence interval [CI]: −0.9 to 2.1 days) and 5.6 ± 2.1 days (95% CI: 1.4 - 9.7 days) shorter among patients who received prolonged PIP/TAZ infusion. At hospital discharge, 19 (15.3%) intermittent infusion and 74 (17.2%) prolonged infusion recipients had died. In comparison to intermittent infusion recipients, the adjusted odds ratio for mortality was 1.17 (95% CI: 0.65-2.1) with prolonged infusion. Conclusion: Our study demonstrated a reduction in hospital LOS with prolonged PIP/TAZ infusion among critically ill patients. Randomized trials are needed to further validate these findings.

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