scholarly journals Prevalence of Chronic Metabolic Comorbidities in Acute Pancreatitis and Its Impact on Early Gastrointestinal Symptoms during Hospitalization: A Prospective Cohort Study

2021 ◽  
pp. 111-117
Author(s):  
Rachel Goodger ◽  
Kanageswari Singaram ◽  
Maxim S. Petrov

<b><i>Background:</i></b> The prevalence of chronic comorbidities is increasing worldwide, and this has been paralleled by a growing interest in how these comorbidities affect patients with acute pancreatitis. The aim was to investigate the associations between pre-existing diabetes mellitus, obesity, metabolic syndrome, and gastrointestinal symptoms during the early course of acute pancreatitis. <b><i>Methods:</i></b> This was a prospective cohort study of patients with a primary diagnosis of acute pancreatitis. Study groups were formed based on the presence of metabolic comorbidities (pre-existing diabetes mellitus, obesity, and metabolic syndrome). Patient-reported outcomes (nausea, bloating, and abdominal pain) were collected prospectively every 24 h (including weekends and public holidays) over the first 72 h of hospitalization. <b><i>Results:</i></b> A total of 183 consecutive patients were enrolled. Of them, 111 (61%) had at least one major metabolic comorbidity. Patients with pre-existing diabetes mellitus and those with metabolic syndrome had worse nausea at 49–72 h of hospitalization (<i>p</i> = 0.017 and <i>p</i> = 0.012, respectively), but not at other time points. Bloating and abdominal pain did not differ between the study groupings throughout the study period. The studied patient-reported outcomes did not differ significantly between acute pancreatitis patients with and without obesity at any point in time. <b><i>Conclusion:</i></b> More than 3 out of 5 patients hospitalized for acute pancreatitis have at least one major chronic metabolic comorbidity. The presence of metabolic comorbidities does not considerably and consistently affect early gastrointestinal symptoms in patients with acute pancreatitis.

2018 ◽  
Vol 52 ◽  
pp. 110-119 ◽  
Author(s):  
N. Al-Hadithy ◽  
Alexandra Dehnel ◽  
Alexander George ◽  
Robert Kisiel ◽  
Craig Lunt ◽  
...  

2019 ◽  
Vol 32 (2) ◽  
pp. 247-255 ◽  
Author(s):  
Paula Kelly-Pettersson ◽  
Bodil Samuelsson ◽  
Maria Unbeck ◽  
Olav Muren ◽  
Martin Magnéli ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040200
Author(s):  
Ahmed E Sherif ◽  
Rory McFadyen ◽  
Julia Boyd ◽  
Chiara Ventre ◽  
Margaret Glenwright ◽  
...  

IntroductionSurvivors of acute pancreatitis (AP) have shorter overall survival and increased incidence of new-onset cardiovascular, respiratory, liver and renal disease, diabetes mellitus and cancer compared with the general population, but the mechanisms that explain this are yet to be elucidated. Our aim is to characterise the precise nature and extent of organ dysfunction following an episode of AP.Methods and analysisThis is an observational prospective cohort study in a single centre comprising a University hospital with an acute and emergency receiving unit and clinical research facility. Participants will be adult patient admitted with AP. Participants will undergo assessment at recruitment, 3 months and 3 years. At each time point, multiple biochemical and/or physiological assessments to measure cardiovascular, respiratory, liver, renal and cognitive function, diabetes mellitus and quality of life. Recruitment was from 30 November 2017 to 31 May 2020; last follow-up measurements is due on 31 May 2023. The primary outcome measure is the incidence of new-onset type 3c diabetes mellitus during follow-up. Secondary outcome measures include: quality of life analyses (SF-36, Gastrointestinal Quality of Life Index); montreal cognitive assessment; organ system physiological performance; multiomics predictors of AP severity, detection of premature cellular senescence. In a nested cohort within the main cohort, individuals may also consent to multiparameter MRI scan, echocardiography, pulmonary function testing, cardiopulmonary exercise testing and pulse-wave analysis.Ethics and disseminationThis study has received the following approvals: UK IRAS Number 178615; South-east Scotland Research Ethics Committee number 16/SS/0065. Results will be made available to AP survivors, caregivers, funders and other researchers. Publications will be open-access.Trial registration numbersClinicalTrials.gov Registry (NCT03342716) and ISRCTN50581876; Pre-results.


2018 ◽  
Vol 7 (3) ◽  
pp. 373-385 ◽  
Author(s):  
Patricia A. M. Kracht ◽  
Faydra I. Lieveld ◽  
Linde M. Amelung ◽  
Carina J. R. Verstraete ◽  
Eveline P. Mauser-Bunschoten ◽  
...  

2021 ◽  
Author(s):  
Taketo Kurozumi ◽  
Takahiro Inui ◽  
Yuhei Nakayama ◽  
Akifumi Honda ◽  
Kentaro Matsui ◽  
...  

Abstract Background: Owing to advances in knowledge and technology, salvaging the limbs of patients with severe trauma and injuries is possible. However, severe limb injuries occasionally necessitate amputation because it allows patients to regain their social lives earlier than limb salvaging. Moreover, previous related investigations are retrospective cohort studies or meta-analyses of retrospective studies, and prospective cohort studies of patient-reported outcomes are extremely rare. This single-center, prospective cohort study aimed to compare the patient-reported outcomes at 1 year after injury between limb salvage and amputation and to elucidate whether amputation contributes to early recovery of functionality and quality of life.Methods: We included 47 limbs of 45 patients with severe open fractures of the lower limb and categorized them into limb salvage and amputation groups. They were registered in the Database of Orthopedic Trauma by the Japanese Society for Fracture Repair at our center; data on patient-reported outcomes at 1 year after injury were obtained from this database. The mean patient age was 49.6 years. Patients’ limbs were evaluated using the lower extremity functional scale (LEFS) and Short-Form 8 (SF-8). Early recovery was evaluated using functionality and quality-of-life questionnaires. Nonparametric statistical analyses were conducted.Results: Of the 47 limbs, 34 limbs of 34 patients were salvaged and 13 limbs of 11 patients were amputated. Significant differences were noted between the limb salvage and amputation groups in terms of the LEFS scores (mean: 49.5 vs 33.1, P=0.025) and scores for the mental health component (mean: 48.7 vs 38.7, P=0.003), role–physical component (mean: 42.2 vs 33.3, P=0.026), and mental component summary (mean: 48.2 vs 41.3, P=0.042) of the SF-8. The limb salvage group had better scores than the amputation group. Conclusions: In this study, limb salvage results in better functional and mental health outcomes at 1 year after severe lower limb injury than after amputation. As reconstruction technology has advanced and limb salvaging has become possible, the focus of studies should now be based on the perspective of “how the patient feels”; hence, we believe that the results of this study, which is based on patient-reported outcomes, are meaningful.


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