scholarly journals Risk factors of recurrent acute pancreatitis after conservative treatment in pediatric population: a single-center study

2021 ◽  
Vol 4 (1) ◽  
pp. e000209
Author(s):  
Qipeng Zheng ◽  
Xueqiang Yan ◽  
Liang Ge ◽  
Shujian Zhang ◽  
Yan Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Diagnostic Criteria ◽  
Pediatric Population ◽  
Treatment Strategies ◽  
First Episode ◽  
Initial Attack ◽  
Recurrent Acute Pancreatitis ◽  
Fasting Time ◽  
Independent Risk Factors

BackgroundAlthough complete resolution and recovery occurs in most children with an initial attack of acute pancreatitis (AP), a subset of children may progress to recurrent AP (RAP). RAP has serious effects to the individual and the socioeconomic burden. The aim of this project was to identify the independent risk factors for pediatric RAP so as to provide evidence for its prevention, early diagnosis and treatment.MethodsA retrospective cohort study of children discharged from Tianjin Children’s Hospital from June 2017 to January 2020 was performed. Demographic and clinical variables, treatment strategies, clinical course and outcomes were collected. Independent risk factors of RAP were identified using the logistic regression model.ResultsOf the total 96 enrolled children, 30 (31.3%) developed RAP during the follow-up period. The majority (27/30, 90%) of the children with AP developed RAP within 6 months of their first AP attack. The presence of systemic inflammatory response syndrome (SIRS) [odds ratio (OR)=6.652, 95% confidence interval (CI) 1.989 to 22.247], fasting time (OR=1.267, 95% CI 1.104 to 1.583), whether meet all three AP diagnostic criteria (OR=7.438, 95% CI 1.346 to 41.103) and abnormal amylase/lipase value on the seventh day of hospitalization (OR=3.601, 95% CI 0.972 to 13.342) were independent risk factors of RAP in children.ConclusionsMost children who developed RAP had progressed within 6 months after their first episode of AP. RAP was more common in children who met all three AP diagnostic criteria at initial attack and in children with SIRS, long fasting time and abnormal amylase/lipase value on the seventh day of hospitalization.

scholarly journals Establishment of a Model for Predicting the Recurrence of Recurrent Acute Pancreatitis in A Short Period of Time

2020 ◽  
Author(s):  
Bo Yang ◽  
Peiyun Li ◽  
Honglan Liu ◽  
Xuesong Bai ◽  
Yijun Yu
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Patient Characteristics ◽  
Short Term ◽  
Recurrent Acute Pancreatitis ◽  
Clinical Patient ◽  
Reactive Protein ◽  
Short Period ◽  
Independent Risk Factors

Abstract Background Little is known about what factors affect recurrence of recurrent acute pancreatitis (RAP) in a short-term. We performed a retrospective study of patients with RAP, and used non-invasive and quantitative biomarkers to establish a predictive model, so as to provide a basis for effectively predicting and preventing recurrence of RAP. MethodsWe performed a retrospective study of 261 RAP patients admitted to Dazhou Central Hospital from January 2008 through December 2018. The short-term group (n=138) and the long-term group (n=123) were compared. Eight clinical patient characteristics and past medical history were collected from admission records. The prediction model was developed by independent risk factors，and the model to predict the effects were confirmed by the area under the ROC cure．ResultsThe study found that β2-microglobulin (β2-MG) (OR, 0.534; 95% CI, 0.329 to 0.866) and C-reactive protein (CRP) (OR, 1.01; 95% CI, 1.002 to 1.017) were the independent predictors of short-term recurrence. Based on these Independent risk factors，a predicted model for short-term recurrence in RAP patients was constructed．The model was L=β2-MG -0.016BCRP. The AUC for model was 0.651 and the optimal cut-off value was 0.7414, with a sensitivity of 65.9%and a specificity of 63.4%.ConclusionsA new biomarker-based model for predicting risk of short-term recurrence in patients with RAP was satisfactorily developed. The model utilizing β2-MG and CRP may assist physicians in patient education and decision-making when preventing from recurrent attacks with RAP.

Impact of the Bag Exchange Procedure on Risk of Peritonitis

2010 ◽  
Vol 30 (4) ◽  
pp. 440-447 ◽  
Author(s):  
Jie Dong ◽  
Yuan Chen
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cox Regression ◽  
Face Mask ◽  
First Episode ◽  
Independent Risk Factors ◽  
Randomized Control ◽  
The Relationship ◽  
Control Study

ObjectiveWe studied whether improper bag exchange predicts the first peritonitis episode in continuous ambulatory peritoneal dialysis (CAPD) patients.Patients and MethodsOur single-center prospective observational study of 130 incident urban CAPD patients who started peritoneal dialysis (PD) between March 2005 and August 2008 aimed to determine the relationship between bag exchange procedures examined at the 6th month of PD and risk for a first peritonitis episode. All patients were followed until a first peritonitis episode, censoring, or the end of the study.ResultsThese 130 patients experienced 22 first peritonitis episodes during the 14-month follow-up. During bag exchange evaluation, 51.5% of patients washed their hands improperly, 46.2% failed to check expiration date or bag leakage, and 11.5% forgot to wear a face mask and cap. Patients experiencing peritonitis were more likely to forget to wear a face mask and cap. In multivariate Cox regression model, not wearing a face mask and cap [hazard ratio (HR): 7.26; 95% confidence interval (CI): 2.6 to 20.1; p < 0.001] and having anemia (HR: 0.96; 95% CI: 0.94 to 0.99; p = 0.005) were independent risk factors for a first episode of peritonitis.ConclusionsNot wearing a face mask and cap and having anemia were independent risk factors for peritonitis. A further randomized control study needs to verify the correlation between improper bag exchange technique and peritonitis in PD patients.

scholarly journals Risk factors for traumatic blunt cerebrovascular injury diagnosed by computed tomography angiography in the pediatric population: a retrospective cohort study

2015 ◽  
Vol 15 (6) ◽  
pp. 599-606 ◽  
Author(s):  
Vijay M. Ravindra ◽  
Jay Riva-Cambrin ◽  
Walavan Sivakumar ◽  
Ryan R. Metzger ◽  
Robert J. Bollo
Keyword(s):  
Risk Factors ◽  
Neurological Deficit ◽  
Pediatric Population ◽  
Blunt Cerebrovascular Injury ◽  
Focal Neurological Deficit ◽  
Cerebrovascular Injury ◽  
Cranial Trauma ◽  
Carotid Canal ◽  
Independent Risk Factors ◽  
Gcs Score

OBJECT Computed tomography angiography (CTA) is frequently used to examine patients for blunt cerebrovascular injury (BCVI) after cranial trauma, but the pediatric population at risk for BCVI is poorly defined. Although CTA is effective for BCVI screening in adults, the increased lifetime risk for malignant tumors associated with this screening modality warrants efforts to reduce its use in children. The authors' objective was to evaluate the incidence of BCVI diagnosed by CTA in a pediatric patient cohort and to create a prediction model to identify children at high risk for BCVI. METHODS Demographic, clinical, and radiographic data were collected retrospectively for pediatric patients who underwent CTA during examination for traumatic cranial injury from 2003 through 2013. The primary outcome was injury to the carotid or vertebral artery diagnosed by CTA. RESULTS The authors identified 234 patients (mean age 8.3 years, range 0.04–17 years, 150 [64%] boys) who underwent CTA screening for BCVI. Of these, 24 (10.3%) had a focal neurological deficit, and 153 (65.4%) had intracranial hemorrhage on a head CTA. Thirty-seven BCVIs were observed in 36 patients (15.4%), and 16 patients (6.8%) died. Multivariate regression analysis identified fracture through the carotid canal, petrous temporal bone fracture, Glasgow Coma Scale (GCS) score of < 8, focal neurological deficit, and stroke on initial CT scan as independent risk factors for BCVI. A prediction model for identifying children at high risk for BCVI was created. A score of ≤ 2 yielded a 7.9% probability of BCVI and a score of ≥ 3 a risk of 39.3% for BCVI. CONCLUSIONS For cranial trauma in children, fracture of the petrous temporal bone or through the carotid canal, focal neurological deficit, stroke, and a GCS score of < 8 are independent risk factors for BCVI.

Risk Factors of Hyperglycemia in Patients After a First Episode of Acute Pancreatitis

Pancreas ◽  
2017 ◽  
Vol 46 (2) ◽  
pp. 209-218 ◽  
Author(s):  
Lin Yuan ◽  
Mengdie Tang ◽  
Lin Huang ◽  
Yi Gao ◽  
Xueliang Li
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
First Episode

scholarly journals Risk Factors for Metachronous Isolated Peritoneal Metastasis after Preoperative Chemotherapy and Potentially Curative Gastric Cancer Resection: Results from the CRITICS Trial

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4626
Author(s):  
Irene A. Caspers ◽  
Karolina Sikorska ◽  
Astrid E. Slagter ◽  
Romy M. van Amelsfoort ◽  
Elma Meershoek-Klein Kranenbarg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Preoperative Chemotherapy ◽  
Peritoneal Metastasis ◽  
Risk Model ◽  
Treatment Strategies ◽  
Histological Subtype ◽  
Multivariable Analyses ◽  
Independent Risk Factors

Gastric cancer (GC) patients at high risk of developing peritoneal metastasis (PM) as a single site of metastasis after curative treatment may be candidates for adjuvant prophylactic strategies. Here we investigated risk factors for metachronous isolated PM in patients who were treated in the CRITICS trial (NCT00407186). Univariable and multivariable analyses on both metachronous isolated PM and ‘other events’, i.e., (concurrent) distant metastasis, locoregional recurrence or death, were performed using a competing risk model and summarized by cumulative incidences. Isolated PM occurred in 64 of the 606 (11%) included patients. Diffuse or mixed histological subtype, ypT4 tumor stage and LNhigh (ypN3 lymph node stage or a lymph node ratio >20%) were independent risk factors for isolated PM in both univariable and multivariable analyses. Likewise, LNhigh was an independent risk factor for ‘other events’. Patients with tumors who were positive for all three independent risk factors had the highest two-year cumulative incidence of 43% for isolated PM development. In conclusion, diffuse or mixed histological subtype, ypT4 and LNhigh were identified as independent risk factors for isolated PM in patients treated with preoperative chemotherapy followed by surgical resection. The combination of these factors may identify a subgroup that may benefit from PM-preventing treatment strategies.

scholarly journals Nomogram for Predicting Persistent Organ Failure with Acute Pancreatitis in Pregnancy

2022 ◽  
Author(s):  
Chengcheng Sheng ◽  
Zongxu Xu ◽  
Jun Wang
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Organ Failure ◽  
Multivariate Logistic Regression Analysis ◽  
Concordance Index ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors ◽  
In Pregnancy

Abstract Background: Acute pancreatitis in pregnancy (APIP) with persistent organ failure (POF) poses a high risk of death for mother and fetus. This study sought to create a nomogram model for early prediction of POF with APIP patients.Methods: We conducted a cross-sectional study on APIP patients with organ failure (OF) between January 2012 and March 2021 in a university hospital. 131 patients were collected. Their clinical courses and pregnancy outcomes were obtained. Risk factors for POF were identified by univariate and multivariate logistic regression analysis. Prediction models with POF were built and nomogram was plotted. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots.Results: Hypertriglyceridemia was the most common etiology in this group of APIP patients, which accounted for 50% of transient organ failure (TOF) and 72.3% of POF. All in-hospital maternal death was in the POF group (P<0.05), which also had a significantly higher perinatal mortality rate than the TOF group (P<0.05). Univariate and multivariate logistic regression analysis determined that lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were independent risk factors for predicting POF in APIP. A nomogram for POF was created by using the four indicators. The area under the curve was 0.875 (95% confidence interval 0.80–0.95). The nomogram had a bootstrapped-concordance index of 0.85 and was well-calibrated.Conclusions: Hypertriglyceridemia was the leading cause of organ failure-related APIP. Lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were the independent risk factors of POF in APIP. Our nomogram model showed an effective prediction of POF with the four indicators in APIP patients.

scholarly journals Diabetes and Younger Age Are Vital and Independent Risk Factors for Acute Pancreatitis in Patients with Severe Hypertriglyceridemia

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Qiang Li ◽  
Chaoqun Hou ◽  
Yunpeng Peng ◽  
Xiaole Zhu ◽  
Chenyuan Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Severe Hypertriglyceridemia ◽  
Younger Age ◽  
History Of ◽  
Independent Risk Factors

Background. The incidence of hypertriglyceridemia-induced acute pancreatitis (HIAP) is increasing worldwide, and now it is the third leading cause of acute pancreatitis in the United States. But, there are only 5% of patients with severe hypertriglyceridemia (>1000 mg/dl) which might generate acute pancreatitis. In order to explore which part of the patients is easy to develop into pancreatitis, a case-control study was performed by us to consider which patient population tend to develop acute pancreatitis in patients with severe hypertriglyceridemia. To perform a retrospective case-control study, we identified severe hypertriglyceridemia patients without AP (HNAP) and with HIAP with a fasting triglyceride level of >1000 mg/dl from The First Affiliated Hospital of Nanjing Medical University during January 1, 2014, to December 31, 2016. Baseline patient characteristics, comorbidities, and risk factors were recorded and evaluated by the univariate and multivariate logistic regression analysis for HIAP and HNAP patients. A total of 124 patients with severe hypertriglyceridemia were included in this study; of which, 62 patients were in the HIAP group and 62 were in the HNAP group. Univariate logistic regression analysis showed that there was no gender difference in both groups; however, there were more younger patients in the HIAP group than in the HNAP group (P value < 0.001), and the HIAP group had low level of high-density lipoprotein compared to the HNAP group (P<0.05). Meanwhile, the presence of pancreatitis was associated with higher level of glycemia and a history of diabetes (P<0.05). Multivariate logistic regression analysis indicated that a history of diabetes and younger age were independent risk factors for acute pancreatitis in patients with severe hypertriglyceridemia. Uncontrolled diabetes and younger age are potential risk factors in patients with severe hypertriglyceridemia to develop acute pancreatitis.

PREVALENCE OF SPINK 1 AND CASR GENE MUTATIONS IN ACUTE AND RECURRENT ACUTE PANCREATITIS : A STUDY FROM CENTRAL INDIA

2021 ◽  
pp. 62-65
Author(s):  
Mohd Talha Noor ◽  
Rahul Sudan ◽  
Vipin Goyal ◽  
Susmit Kosta ◽  
Ravindra Kumar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Gene Mutation ◽  
Genetic Factors ◽  
Receptor Gene ◽  
Gene Mutations ◽  
Recurrent Acute Pancreatitis ◽  
Casr Gene ◽  
Increased Risk ◽  
Spink 1

Background: Genetic factors may play an important role in the pathogenesis of acute pancreatitis. It has been observed in various studies that the presence of risk factors alone like alcohol abuse or gall bladder stones does not lead to attacks of pancreatitis in all the patients. This leads to assumption that genetic factors may decrease the threshold for the development of pancreatitis in presence of one or more risk factors. We observed that there is a paucity of data regarding the role of genetics in acute pancreatitis (AP) and recurrent acute pancreatitis (RAP) in our part of the world and we aimed at studying the prevalence of genetic mutations in such patients. Methods: Our study intended to nd the prevalence of SPINK1 N34S (Serine protease inhibitor kazal type 1) and CaSR (Calcium sensing receptor) gene mutations in patients of AP and RAP. A total of 50 patients and 25 age and gender matched controls entered our study. Blood samples were obtained from all the cases and controls for routine investigations and genetic analysis. SPINK 1 N34S and CaSR gene mutation studies were done in all the patients and controls. Results: Alcohol (64%) followed by gallbladder stone disease (20%) was the most common aetiology of pancreatitis. SPINK 1 N34S mutation was present in 21 patients and 2 controls whereas CaSR gene mutation was present in 13 patients and 2 controls. Patients with SPINK 1 N34S and CaSR gene mutations were younger than the patients without these mutations. Prevalence of both SPINK1 N34S and CaSR gene mutations was higher in patients of RAP than AP. These mutations were not associated with aetiology or severity of pancreatitis. Conclusion: The prevalence SPINK 1 N34S and CaSR gene mutations was higher in patients of AP and RAP. Identication of these mutations in patients of AP can help in the identication of patients who are at increased risk of recurrent attacks of AP

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