scholarly journals IDDF2021-ABS-0134 Organ failure and infected pancreatic necrosis as determinants of mortality in patients with acute pancreatitis: an updated systematic review and meta-analysis

2021 ◽  
Author(s):  
Wenmo Hu ◽  
Yuelun Zhang ◽  
Tianrui Hua ◽  
Guorong Chen ◽  
Kai Song ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Pancreatitis ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Meta Analysis ◽  
Infected Pancreatic Necrosis

591c Primary Organ Failure and Secondary Organ Failure Due to Infected Pancreatic Necrosis Contribute Independently to Mortality in Acute Pancreatitis and Should Be Distinguished

2015 ◽  
Vol 148 (4) ◽  
pp. S-114
Author(s):  
Pramod K. Garg ◽  
Rajesh K. Padhan ◽  
Padmaprakash K. Vadiraja ◽  
Sanatan Behra ◽  
Sushil K. Jain ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Infected Pancreatic Necrosis

scholarly journals Occurrence and Risk Factors of Infected Pancreatic Necrosis in Intensive Care Unit–Treated Patients with Necrotizing Severe Acute Pancreatitis

2021 ◽  
Author(s):  
Henrik Leonard Husu ◽  
Miia Maaria Valkonen ◽  
Ari Kalevi Leppäniemi ◽  
Panu Juhani Mentula
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Organ Failure ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Open Abdomen ◽  
Infected Pancreatic Necrosis ◽  
Independent Risk Factors

Abstract Background In patients with severe acute pancreatitis (SAP), infected pancreatic necrosis (IPN) is associated with a worsened outcome. We studied risk factors and consequences of IPN in patients with necrotizing SAP. Methods The study consisted of a retrospective cohort of 163 consecutive patients treated for necrotizing SAP at a university hospital intensive care unit (ICU) between 2010 and 2018. Results All patients had experienced at least one persistent organ failure and approximately 60% had multiple organ failure within the first 24 h from admission to the ICU. Forty-seven (28.8%) patients had IPN within 90 days. Independent risk factors for IPN were more extensive anatomical spread of necrotic collections (unilateral paracolic or retromesenteric (OR 5.7, 95% CI 1.5–21.1) and widespread (OR 21.8, 95% CI 6.1–77.8)) compared to local collections around the pancreas, postinterventional pancreatitis (OR 13.5, 95% CI 2.4–76.5), preceding bacteremia (OR 4.8, 95% CI 1.3–17.6), and preceding open abdomen treatment for abdominal compartment syndrome (OR 3.6, 95% CI 1.4–9.3). Patients with IPN had longer ICU and overall hospital lengths of stay, higher risk for necrosectomy, and higher readmission rate to ICU. Conclusions Wide anatomical spread of necrotic collections, postinterventional etiology, preceding bacteremia, and preceding open abdomen treatment were identified as independent risk factors for IPN.

The value of procalcitonin at predicting the severity of acute pancreatitis and development of infected pancreatic necrosis: Systematic review

Surgery ◽  
2009 ◽  
Vol 146 (1) ◽  
pp. 72-81 ◽  
Author(s):  
Reza Mofidi ◽  
Stuart A. Suttie ◽  
Pradeep V. Patil ◽  
Simon Ogston ◽  
Rowan W. Parks
Keyword(s):  
Systematic Review ◽  
Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Infected Pancreatic Necrosis

scholarly journals The Use of Prophylaxis Antibiotics to Prevent Acute Pancreatitis Complications: Meta-Analysis of Clinical Trials

2022 ◽  
Vol 22 (3) ◽  
pp. 196-202
Author(s):  
Dwita Nitoya Esterini ◽  
Kirsten Putriani Hartman ◽  
Joue Abraham Trixie ◽  
Yessi Setianegari ◽  
Kurniyanto Kurniyanto
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Data Extraction ◽  
Meta Analysis ◽  
Infected Pancreatic Necrosis ◽  
Definitive Treatment ◽  
Medical Database ◽  
Infected Necrosis ◽  
Risk Of Mortality ◽  
Significant Difference

Background: Acute pancreatitis (AP) is an inflammation of the pancreas, a serious emergency with no definitive treatment. It may progress to infected necrosis, non-pancreatitis infection, also death that may occur within the first 1 to 2 weeks. The use of prophylactic antibiotics in AP to prevent complications remains a controversy. The objective of this meta-analysis is to assess the benefit of prophylaxis antibiotics administration to prevent the complication.Method: Trials were identified by searching the medical database. Literature range is within the year 1975 to 2021.  Review Manager 5.4.1 was used to analyse data extraction and risk of bias of included studies were elaborated. Risk ratio (RR) was calculated with 95% confidence interval (CI). P 0.05 was considered significant.Results: Twenty trials with a total of 1.287 patients of AP were analysed; 646 patients treated with antibiotic prophylaxis and 641 patients treated with placebo. Prophylaxis antibiotics were found to have significant difference between the two groups. The administration of prophylaxis antibiotics lower the risk of non-pancreatic infections (RR = 0.77; 95% CI: 0.62–0.95; p 0.05) and infected pancreatic necrosis (RR = 0.74; 95% CI: 0.58-0.94; p 0.05). Meanwhile, prophylaxis antibiotics were found to be insignificant to lower the risk of mortality (RR = 0.75; 95% CI: 0.54-1.03; p 0.05). Conclusion: Prophylaxis antibiotics lower the risk of non-pancreatic infections and infected pancreatic necrosis, but did not lower the risk of mortality.

scholarly journals Synchronous Organ Failure and Infected Pancreatic Necrosis Define Genuine Critical Acute Pancreatitis

2021 ◽  
Author(s):  
Dingcheng Shen ◽  
Qin Wei ◽  
Haosu Huang ◽  
Caihong Ning ◽  
Jiarong Li ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Tertiary Hospital ◽  
Adverse Outcomes ◽  
Infected Pancreatic Necrosis ◽  
Mortality And Morbidity ◽  
Surgical Interventions ◽  
Icu Length Of Stay ◽  
Definition Of

Abstract Background: The determinant-based classification (DBC) of acute pancreatitis (AP) was proposed in 2012. One of the highlights of the DBC was critical acute pancreatitis (CAP), which was supposed to be strongly associated with the highest risk of adverse outcomes. However, the definition of CAP needs to be further clarified.Methods: A prospective cohort with consecutive patients of infected pancreatic necrosis (IPN) at a tertiary hospital was analyzed. Patients were assigned to IPN alone, Metachronous-CAP (MCAP) and Synchronous-CAP group (SCAP) according to presence or absence of organ failure (OF) and the crosstalk between OF and IPN. Clinical interventions and outcomes were compared among groups.Results: A total of 248 IPN patients were enrolled and the overall mortality was 25.8%. Compared with MCAP, patients with SCAP were associated with higher mortality (45/68, 66.2% vs. 5/50, 10.0%; OR= 17.6,95% CI, 6.2-50.4; P < 0.001) and morbidity (28/68, 41.2% vs. 9/50, 18.0%; P = 0.013), longer duration of OF (median 35.5 days vs. 12.0 days, P < 0.001), longer ICU length of stay (LOS) (median 28.0 days vs. 16.0 days, P = 0.001), longer hospital LOS (median 67.0 days vs. 60.0 days, P < 0.001) as well as earlier requirement for surgical interventions. The IPN alone and MCAP had comparable mortality (10.8% vs. 10.0%, P = 0.88), morbidity and hospital LOS, except that MCAP patients were characterized with longer duration of OF and ICU LOS (P< 0.05).Conclusions: SCAP, characterized with synchronous persistent OF and IPN, was associated with higher mortality and morbidity and should be defined as genuine CAP.

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