scholarly journals Increased circulating total bile acid levels were associated with organ failure in patients with acute pancreatitis

2020 ◽  
Author(s):  
Weiqin Li ◽  
Xiaochun Xie ◽  
Jie Dong ◽  
Guotao Lu ◽  
Kun Gao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Regression Analysis ◽  
Bile Acid ◽  
Organ Failure ◽  
Roc Curve ◽  
Pancreatic Necrosis ◽  
Early Stage ◽  
Total Bile Acid ◽  
Percutaneous Catheter Drainage ◽  
Tertiary Center

Abstract Background: Recent studies have shown that bile acids (BAs) are closely related to metabolic and inflammatory diseases. Our study aimed to investigate whether circulating total bile acid (TBA) levels were associated with the severity of acute pancreatitis (AP).Methods: We retrospectively collected data on patients diagnosed with AP in a tertiary center from 01 January 2014 to 31 December 2016. The highest TBA value during the first 1,2,3,5,7 days after admission was determined as D1, D2, D3, D5, D7 TBAmax. Patients were divided into the high TBA (HTBA) group and the normal TBA (NTBA) group according to whether the TBAmax was ≥10μmol/L. The prognosis and complications, including death, organ failure (OF) and pancreatic necrosis, were compared between the two groups. Logistic regression analysis and receiving operating characteristic (ROC) curve were used to evaluate the relationship between circulating TBA and organ failure in AP patients.Results: Through stratified analysis of each time period, we found that the incidence of OF in the HTBA group was significantly higher than that in the NTBA group, and the AP severity classification in the HTBA group was more serious than that in the NTBA group. In addition, according to the D7 TBAmax values, the pancreatic necrosis rate, percutaneous catheter drainage (PCD) rate and mortality in the HTBA group were higher than those in the NTBA group. Multivariate regression analysis showed that HTBA (odds ratio (OR), 4.894; P = 0.002) was an independent risk factor for AP complicated with OF, which was verified in the grouping based on D7 TBAmax. ROC analysis revealed that a circulating D7 TBAmax cutoff point of 6.450 umol/L had optimal predictive value for the development of OF in AP patients with an area under the curve of the ROC curve (AUCROC) of 0.777. Conclusions: The increase of circulating TBA in early stage of AP is independently related to organ failure, which indicates the adverse prognosis of AP patients.

scholarly journals Increased circulating total bile acid levels were associated with organ failure in patients with acute pancreatitis

2020 ◽  
Author(s):  
Weiqin Li ◽  
Xiaochun Xie ◽  
Jie Dong ◽  
Guotao Lu ◽  
Kun Gao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Regression Analysis ◽  
Bile Acid ◽  
Organ Failure ◽  
Roc Curve ◽  
Pancreatic Necrosis ◽  
Early Stage ◽  
Total Bile Acid ◽  
Percutaneous Catheter Drainage ◽  
Tertiary Center

Abstract Background Recent studies have shown that bile acids (BAs) are closely related to metabolic and inflammatory diseases. Our study aimed to investigate whether circulating total bile acid (TBA) levels were associated with the severity of acute pancreatitis (AP). Methods We retrospectively collected data on patients diagnosed with AP in a tertiary center from 01 January 2014 to 31 December 2016. The highest TBA value during the first 1,2,3,5,7 days after admission was determined as D1, D2, D3, D5, D7 TBA max . Patients were divided into the high TBA (HTBA) group and the normal TBA (NTBA) group according to whether the TBA max was ≥10μmol/L. The prognosis and complications, including death, organ failure (OF) and pancreatic necrosis, were compared between the two groups. Logistic regression analysis and receiving operating characteristic (ROC) curve were used to evaluate the relationship between circulating TBA and organ failure in AP patients. Results Through stratified analysis of each time period, we found that the incidence of OF in the HTBA group was significantly higher than that in the NTBA group, and the AP severity classification in the HTBA group was more serious than that in the NTBA group. In addition, according to the D7 TBA max values, the pancreatic necrosis rate, percutaneous catheter drainage (PCD) rate and mortality in the HTBA group were higher than those in the NTBA group. Multivariate regression analysis showed that HTBA (odds ratio (OR), 4.894; P = 0.002) was an independent risk factor for AP complicated with OF, which was verified in the grouping based on D7 TBA max . ROC analysis revealed that a circulating D7 TBA max cutoff point of 6.450 umol/L had optimal predictive value for the development of OF in AP patients with an area under the curve of the ROC curve (AUCROC) of 0.777. Conclusions The increase of circulating TBA in early stage of AP is independently related to organ failure, which indicates the adverse prognosis of AP patients.

scholarly journals Increased circulating total bile acid levels were associated with organ failure in patients with acute pancreatitis

2020 ◽  
Author(s):  
Weiqin Li ◽  
Xiaochun Xie ◽  
Jie Dong ◽  
Guotao Lu ◽  
Kun Gao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Regression Analysis ◽  
Bile Acid ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Early Stage ◽  
Multivariate Logistic Regression Analysis ◽  
Total Bile Acid ◽  
Percutaneous Catheter Drainage ◽  
Tertiary Center

Abstract Background: Recent studies have shown that bile acids (BAs) are closely related to metabolic and inflammatory diseases. Our study aimed to investigate whether circulating total bile acid (TBA) levels were associated with the severity of acute pancreatitis (AP).Methods: We retrospectively collected data on patients diagnosed with AP in a tertiary center from 01 January 2014 to 31 December 2016. Patients were divided into the high TBA (HTBA) group and the normal TBA (NTBA) group according to whether the highest TBA value (TBAmax) within 7 days after admission was ≥10μmol/L. The prognosis and complications, including death, organ failure (OF) and pancreatic necrosis, were compared between the two groups. Univariate and multivariate logistic regression analysis were used to evaluate the relationship between circulating TBA and organ failure in AP patients.Results: 293 patients were included in this study, of whom 18.43% (54/293) were in the HTBA group. The incidence of OF in the HTBA group was significantly higher than that in the NTBA group (59.3% vs 17.2%; P < 0.001), and the AP severity classification in the HTBA group was more serious than that in the NTBA group. The pancreatic necrosis rate, percutaneous catheter drainage (PCD) rate, open surgery rate and mortality rate in the HTBA group were higher than those in the NTBA group. Multivariate regression analysis showed that HTBA (odds ratio (OR), 4.894; P = 0.002) was an independent risk factor for AP complicated with OF. Conclusions: The increase of circulating TBA in early stage of AP is independently related to organ failure, which indicates the adverse prognosis of AP patients.

scholarly journals Increased circulating total bile acid levels were associated with organ failure in patients with acute pancreatitis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaochun Xie ◽  
Jie Dong ◽  
Guotao Lu ◽  
Kun Gao ◽  
Xiaoyao Li ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Bile Acid ◽  
Organ Failure ◽  
Total Bile Acid

scholarly journals HSV encephalitis after successful minimally invasive debridement for infected pancreatic necrosis: A case of rare central nervous system complication

2021 ◽  
Vol 19 ◽  
pp. 205873922110005
Author(s):  
Bei Lu ◽  
Yang Cai ◽  
Junjie Yin ◽  
Jingrui Wang ◽  
Zhong Jia ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Acute Pancreatitis ◽  
Nervous System ◽  
Herpes Simplex ◽  
Minimally Invasive ◽  
Pancreatic Necrosis ◽  
Infected Pancreatic Necrosis ◽  
Percutaneous Catheter Drainage ◽  
Central Nervous System Complication ◽  
Simplex Virus

Patients with acute pancreatitis (AP) often suffer tough complications, some of which are fatal. The early diagnosis and definite treatment of central nervous system (CNS) complications have not been fully achieved yet, which seriously affects the mortality of severe acute pancreatitis (SAP). We present a case of infected pancreatic necrosis (IPN) in a 62-year Chinese man who developed acute herpes simplex encephalitis (HSE) caused by herpes simplex virus type 1 (HSV-1) after favorable minimally invasive retroperitoneal approaches (MIRAs). The patient was successfully treated with 115 days stayed in our hospital. The MIRAs included image-guided retroperitoneal percutaneous catheter drainage (PCD), nephroscopic pancreatic necrosectomy (NPN), and ultrasonic pneumatic lithotripsy system (UPLS) assisted non-narcotic sinus track necrosectomy (NSN). HSE is relatively rare and potentially life threatening. We attempt to discuss the probable risk factors and how the relatively rare HSE are related to the patients of SAP with latent HSV.

Pathophysiology, diagnosis, and assessment of acute pancreatitis

2016 ◽  
Author(s):  
James R. A. Skipworth ◽  
Stephen P. Pereira
Keyword(s):  
Acute Pancreatitis ◽  
Inflammatory Response ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Scoring Systems ◽  
Early Mortality ◽  
Laboratory Assessment ◽  
Optimal Method ◽  
Biphasic Pattern ◽  
Pancreatic Complications

The incidence of acute pancreatitis continues to increase, but the attendant mortality has not decreased for >30 years. The pathogenesis remains poorly understood, but the initial mechanism appears to be intracellular activation of pancreatic enzymes, with micro- and macrovascular dysfunction, in conjunction with a systemic inflammatory response acting as a key propagating factor and determinant of severity. A multitude of causes or initiators exist, but there is a common pathophysiological pathway. The use of conventional scoring systems, combined with repeated clinical and laboratory assessment, remain the optimal method of predicting early severity and organ dysfunction. Death occurs in a biphasic pattern with early mortality (<2 weeks) secondary to SIRS and MODS; and late deaths (>2 weeks) due to superinfection of pancreatic necrosis. Assessment of severity should reflect this, with early severity being diagnosed in the presence of organ failure for >48 hours, and late severity defined by the presence of pancreatic and peri-pancreatic complications on CT or other appropriate imaging modalities.

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.

Sa1366 Organ Failure on Day 1 of Hospitalization Predicts the Development of Pancreatic Necrosis in Patients With Acute Pancreatitis

2013 ◽  
Vol 144 (5) ◽  
pp. S-275
Author(s):  
Elham Afghani ◽  
Venkata S. Akshintala ◽  
Atif Zaheer ◽  
Susan Hutfless ◽  
Mouen Khashab ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Pancreatic Necrosis
Sign in / Sign up

Export Citation Format

Share Document