scholarly journals Risk Factors for Fetal Death and Maternal AP Severity in Acute Pancreatitis in Pregnancy

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiaolei Shi ◽  
Yuepeng Hu ◽  
Na Pu ◽  
Guofu Zhang ◽  
Jingzhu Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Acute Respiratory Distress Syndrome ◽  
Severe Acute Pancreatitis ◽  
Distress Syndrome ◽  
Fetal Death ◽  
Intrauterine Death ◽  
Gestational Week ◽  
Independent Risk Factors ◽  
In Pregnancy

Background: Acute pancreatitis in pregnancy is a rare but highly life-threatening gestational and perinatal disease.Objective: This study aimed to identify the risk factors for fetal death and acute pancreatitis severity.Methods: This retrospective cohort study enrolled patients with acute pancreatitis in pregnancy in our center from January 1, 2012, to August 1, 2020, and classified them according to two clinical endpoints, fetal outcome and disease severity. The groups were examined and compared according to gestational week, etiology, gravidity and parity, complications in pre- and post-delivery, and medical history. Logistic regression analysis was performed to identify the independent risk factors for fetal death and acute pancreatitis severity.Results: Of the 90 enrolled patients, 28 (31.1%) had fetal death and 43 (47.8%) had severe acute pancreatitis. Logistic regression analysis showed that pre-delivery acute respiratory distress syndrome (OR, 5.8; 95% CI, 1.5–22.4; p = 0.010) and gestational week (OR, 0.9; 95% CI, 0.8–1.0; p = 0.011) were risk factors for fetal death. Gestation week (OR, 1.2; 95% CI, 1.1–1.3; p = 0.003) and fetal intrauterine death (OR, 5.9; 95% CI, 1.8–19.4; p = 0.003) were risk factors for severe acute pancreatitis.Conclusions: Pre-delivery acute respiratory distress syndrome and gestational week were independent risk factors for fetal death. Fetal intrauterine death and gestational week were independent risk factors for severe acute pancreatitis.

scholarly journals The risk factors for acute respiratory distress syndrome in patients with severe acute pancreatitis

Medicine ◽  
2021 ◽  
Vol 100 (2) ◽  
pp. e23982
Author(s):  
Weiwei Zhang ◽  
Min Zhang ◽  
Zhiming Kuang ◽  
Zhenfei Huang ◽  
Lin Gao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Severe Acute Pancreatitis ◽  
Distress Syndrome

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 Risk Factors and Distribution of Pathogens for Pulmonary Infection in Patients with Severe Acute Pancreatitis

2021 ◽  
Vol 4 (1) ◽  
pp. 39
Author(s):  
Quanshui Peng ◽  
Peng Chen ◽  
Di He
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Drug Sensitivity ◽  
Pulmonary Infection ◽  
Preventive Measures ◽  
Univariate Analysis ◽  
Independent Risk Factors ◽  
Lung Infections ◽  
Pathogen Spectrum

Objective: To investigate risk factors and distribution of pathogens for pulmonary infection in patients with severe acute pancreatitis. Methods: The clinical data of 285 patients with severe acute pancreatitis were retrospectively analyzed. Sputum specimens of patients with lung infections were studied. Univariate analysis and logistic regression were performed to screening the factors correlating to lung infections. Results: Gram-negative bacilli were the principal microorganisms isolated from those lung infections, and these bacterial pathogens demonstrated a marked pattern of antibiotic resistance. It was identified that age (OR 1.05, 95% CI 1.01-1.09, p=0.01), Ranson scores (OR 3.01 , 95% CI 1.13-8.03, p = 0.03) and surgical treatment  (OR4.27, 95% CI 1.03-17.65, p = 0.04)were independent risk factors of lung infections in patients with severe acute pancreatitis. Conclusion: Analysis of pathogen spectrum and drug sensitivity will contribute to choosing antibiotics empirically. And preventive measures aimed at risk factors could help reduce the incidence of lung infections in patients with severe acute pancreatitis. 

scholarly journals Acute respiratory distress-syndrome in the general complications of severe acute pancreatitis

2019 ◽  
Vol 23 (4) ◽  
pp. 359 ◽  
Author(s):  
Ravshan Aliyevich Ibadov ◽  
Anvar Shamkhatovich Arifjanov ◽  
Sardor Khamdamovich Ibragimov ◽  
Bakhrom Rustamjanovich Abdullajanov
Keyword(s):  
Acute Pancreatitis ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Severe Acute Pancreatitis ◽  
Distress Syndrome

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.

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