scholarly journals Clinical outcomes in acute pancreatitis with relative bradycardia at fever onset

Medicine ◽  
2021 ◽  
Vol 100 (46) ◽  
pp. e27901
Author(s):  
Takeshi Okamoto ◽  
Makoto Arashiyama ◽  
Kenji Nakamura ◽  
Ryosuke Tsugitomi ◽  
Katsuyuki Fukuda
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Outcomes ◽  
Fever Onset

Early short-term continuous high-volume haemofiltration improves clinical outcomes of severe acute pancreatitis

Pancreatology ◽  
2013 ◽  
Vol 13 (3) ◽  
pp. S68
Author(s):  
Wei Huang ◽  
Jia Guo ◽  
Xiao Yang ◽  
Tao Jin ◽  
Kiran Altaf ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Outcomes ◽  
Severe Acute Pancreatitis ◽  
High Volume ◽  
Short Term

scholarly journals Novel phenotypes of coronavirus disease: a temperature-based trajectory model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yanfei Shen ◽  
Dechang Chen ◽  
Xinmei Huang ◽  
Guolong Cai ◽  
Qianghong Xu ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Odds Ratio ◽  
Gamma Globulin ◽  
Inflammatory Responses ◽  
Potential Temperature ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Fever Onset ◽  
Tertiary Hospitals

Abstract Background Coronavirus disease has heterogeneous clinical features; however, the reasons for the heterogeneity are poorly understood. This study aimed to identify clinical phenotypes according to patients’ temperature trajectory. Method A retrospective review was conducted in five tertiary hospitals in Hubei Province from November 2019 to March 2020. We explored potential temperature-based trajectory phenotypes and assessed patients’ clinical outcomes, inflammatory response, and response to immunotherapy according to phenotypes. Results A total of 1580 patients were included. Four temperature-based trajectory phenotypes were identified: normothermic (Phenotype 1); fever, rapid defervescence (Phenotype 2); gradual fever onset (Phenotype 3); and fever, slow defervescence (Phenotype 4). Compared with Phenotypes 1 and 2, Phenotypes 3 and 4 had a significantly higher C-reactive protein level and neutrophil count and a significantly lower lymphocyte count. After adjusting for confounders, Phenotypes 3 and 4 had higher in-hospital mortality (adjusted odds ratio and 95% confidence interval 2.1, 1.1–4.0; and 3.3, 1.4–8.2, respectively), while Phenotype 2 had similar mortality, compared with Phenotype 1. Corticosteroid use was associated with significantly higher in-hospital mortality in Phenotypes 1 and 2, but not in Phenotypes 3 or 4 (p for interaction < 0.01). A similar trend was observed for gamma-globulin. Conclusions Patients with different temperature-trajectory phenotypes had different inflammatory responses, clinical outcomes, and responses to corticosteroid therapy.

Clinical Outcomes of Acute Pancreatitis in Patients with Cirrhosis According to Liver Disease Severity Scores

2020 ◽  
Author(s):  
C. Roberto Simons-Linares ◽  
Suha Abushamma ◽  
Carlos Romero-Marrero ◽  
Amit Bhatt ◽  
Rocio Lopez ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Liver Disease ◽  
Clinical Outcomes ◽  
Disease Severity ◽  
Severity Scores ◽  
Disease Severity Scores

scholarly journals 604 – Impact of Statin Use on Clinical Outcomes in Patients with Acute Pancreatitis: A 10 Year Propensity Adjusted Data Analysis

2019 ◽  
Vol 156 (6) ◽  
pp. S-121-S-122
Author(s):  
Ruchit N. Shah ◽  
Harshit S. Khara ◽  
Andrea L. Berger ◽  
Bradley Confer ◽  
Amitpal S. Johal ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Data Analysis ◽  
Clinical Outcomes ◽  
Statin Use

scholarly journals New Predictor of Organ Failure in Acute Pancreatitis: CD4+ T Lymphocytes and CD19+ B Lymphocytes

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Chenyuan Shi ◽  
Chaoqun Hou ◽  
Xiaole Zhu ◽  
Yunpeng Peng ◽  
Feng Guo ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
T Lymphocytes ◽  
Organ Failure ◽  
Clinical Outcomes ◽  
B Lymphocytes ◽  
T Lymphocyte ◽  
Roc Curve ◽  
Scoring Systems ◽  
Gallstone Pancreatitis ◽  
Effector Cells

Objective. Lymphocytes are one of the main effector cells in the inflammatory response of acute pancreatitis (AP). The purpose of the study was to evaluate whether peripheral blood lymphocyte (PBL) subsets at admission change during AP based on clinical outcomes and to explore whether these changes vary by aetiology of AP. Hence, we performed a prospective study to find a predictor in lymphocyte subsets that might allow easier, earlier, and more accurate prediction of clinical outcomes. Methods. Patients with AP were enrolled from December 2017 to June 2018 at the First Affiliated Hospital of Nanjing Medical University. Age, sex, clinical and biochemical parameters, and aetiology of AP were obtained at admission. PBL counts were assessed within 24 hours after admission. Clinical outcomes were observed as endpoints. The areas under the curve (AUCs) of different predictors were calculated using the receiver operating characteristic (ROC) curve. Results. Overall, 133 patients were included. Patients (n=24) with organ failure (OF) had significantly lower CD4+ T lymphocyte levels than those (n=109) with No OF (NOF) (39.60 (33.94-46.13) vs. 32.41 (26.51-38.00), P=0.004). The OF group exhibited significantly higher CD19+ B lymphocytes than the NOF group (16.07 (10.67-21.06) vs. 23.78 (17.84-29.45), P=0.001). Of the AP cases, 68.8% were caused by gallstones; 10.1% were attributed to alcohol; 16.5% were due to hyperlipidaemia; and 4.6% had other causes. Across all aetiologies, a lower CD4+ T lymphocyte level was significantly related to OF (P<0.05). However, CD19+ B lymphocytes were significant only in gallstone pancreatitis (P<0.05). The ROC curve results showed that the AUC values of CD4+T lymphocytes, CD19+ B lymphocytes, and combined CD4+T lymphocytes and CD19+ B lymphocytes were similar to those of traditional scoring systems, such as APACHEII and Ranson. Conclusions. CD4+ T and CD19+ B lymphocytes during the early phase of AP can predict OF.

scholarly journals The Effect of Plasma Triglyceride-Lowering Therapy on the Evolution of Organ Function in Early Hypertriglyceridemia-Induced Acute Pancreatitis Patients With Worrisome Features (PERFORM Study): Rationale and Design of a Multicenter, Prospective, Observational, Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Longxiang Cao ◽  
Jing Zhou ◽  
Mingzhi Chen ◽  
Tao Chen ◽  
Man Liu ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cohort Study ◽  
Organ Failure ◽  
Clinical Outcomes ◽  
Multiple Organ ◽  
Primary Objective ◽  
Organ Support ◽  
Lowering Therapy ◽  
Observational Prospective Cohort Study ◽  
New Onset

Background: Acute pancreatitis (AP) is a potentially life-threatening inflammatory disease with multiple etiologies. The prevalence of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) has been increasing in recent years. It is reported that early triglyceride (TG) levels were associated with the severity of the disease, and TG- lowering therapies, including medical treatment and blood purification, may impact the clinical outcomes. However, there is no consensus regarding the optimal TG-lowering therapy, and clinical practice varies greatly among different centers. Our objective is to evaluate the TG-lowering effects of different therapies and their impact on clinical outcomes in HTG-AP patients with worrisome features.Methods: This is a multicenter, observational, prospective cohort study. A total of approximately 300 patients with HTG-AP with worrisome features are planned to be enrolled. The primary objective of the study is to evaluate the relationship between TG decline and the evolution of organ failure, and patients will be dichotomized depending on the rate of TG decline. The primary outcome is organ failure (OF) free days to 14 days after enrollment. Secondary outcomes include new-onset organ failure, new-onset multiple-organ failure (MOF), new-onset persistent organ failure (POF), new receipt of organ support, requirement of ICU admission, ICU free days to day 14, hospital free days to day 14, 60-day mortality, AP severity grade (Based on the Revised Atlanta Classification), and incidence of systemic and local complications. Generalized linear model (GLM), Fine and Gray competing risk regression, and propensity score matching will be used for statistical analysis.Discussion: Results of this study will reveal the current practice of TG-lowering therapy in HTG-AP and provide necessary data for future trials.

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