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Mortality in acute pancreatitis with persistent organ failure is determined by the number, type, and sequence of organ systems affected
- Source :
- United European gastroenterology journal, Thousand Oaks, CA : Sage Publicaions Inc., 2021, vol. 9, no. 2, p. 139-149, United European Gastroenterology Journal, r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante, instname
- Publication Year :
- 2021
-
Abstract
- Background Persistent organ failure (POF) is the strongest determinant of mortality in acute pancreatitis (AP). There is a paucity of data regarding the impact of different POF attributes on mortality and the role of different characteristics of systemic inflammatory response syndrome (SIRS) in the risk of developing POF. Objective We aimed to assess the association of POF dynamic features with mortality and SIRS characteristics with POF. Methods We studied 1544 AP subjects prospectively enrolled at 22 international centers (APPRENTICE consortium). First, we estimated the association of onset, duration, and maximal score of SIRS with POF. Then, we evaluated the risk of mortality based on POF onset, duration, number, type, and sequence of organs affected. Analyses were adjusted for potential confounders. Results 58% had SIRS, 11% developed POF, and 2.5% died. Early SIRS, persistent SIRS, and maximal SIRS score ≥ 3 were independently associated with higher risk of POF (p<br />Key Summary What is known? Persistent organ failure (POF; >48 h) is the strongest determinant of mortality in acute pancreatitis (AP).There is lack of evidence on the impact of different attributes of failing organs on AP mortality.The association of systemic inflammatory response syndrome (SIRS) characteristics with POF, has not been well studied. What is new here? Mortality risk in AP patients with POF is determined by the number, type, and sequence of organ systems affected.Multiple POF affecting the cardiovascular and respiratory systems first or concurrently carries the highest mortality in AP compared to the renal system.Involvement of the renal system as the first failing organ or concurrently with other organs during multiple POF is associated with lower mortality than respiratoy or cardiovascular systems as first failing organs.Onset and duration of POF are not associated with mortality in AP patients.SIRS on admission, persistent SIRS, and three to four SIRS criteria, are independently associated with higher risk of POF.
- Subjects :
- Male
medicine.medical_specialty
Number Type
acute pancreatitis
endocrine system diseases
Multiple Organ Failure
Severity of Illness Index
Gastroenterology
systemic inflammatory response syndrome, severe acute pancreatitis
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Risk of mortality
medicine
Humans
organ failure
Prospective Studies
Respiratory system
Pancreas
Organ system
mortality
natural history
business.industry
Confounding
Odds ratio
Middle Aged
medicine.disease
Systemic Inflammatory Response Syndrome
female genital diseases and pregnancy complications
Systemic inflammatory response syndrome
systemic inflammatory response syndrome
Pancreatitis
Oncology
030220 oncology & carcinogenesis
Disease Progression
Acute pancreatitis
Female
Original Article
030211 gastroenterology & hepatology
business
severe acute pancreatitis
Subjects
Details
- Language :
- English
- ISSN :
- 20506406 and 20506414
- Database :
- OpenAIRE
- Journal :
- United European gastroenterology journal, Thousand Oaks, CA : Sage Publicaions Inc., 2021, vol. 9, no. 2, p. 139-149, United European Gastroenterology Journal, r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante, instname
- Accession number :
- edsair.doi.dedup.....01b8e1d9b743e3aa510cdea9e1f2325f