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Fluid sequestration is a useful parameter in the early identification of severe disease of acute pancreatitis
- Source :
- Journal of Gastroenterology. 54:359-366
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Early identification of severe disease of acute pancreatitis (AP) is of critical importance to improve the prognosis. Fluid sequestration (FS), calculated from administrated fluid and fluid output, is a simple prognostic parameter. We examined its utility in the early phase of AP. We retrospectively investigated AP patients between January 2009 and April 2017. We compared FS in the first 24 h (FS24) with FS in the first 48 h (FS48) and administrated fluid volume within the first 24 h (FV24). Diagnostic yield for predicting intensive care unit (ICU) admission and persistent organ failure (POF) was assessed using receiver operating characteristic curves. We also evaluated risk factors for developing severe disease of AP. A total of 400 AP patients were included in the analysis (median age 64 years; male 60%). According to the Japanese severity criteria, 158 patients (40%) were diagnosed as severe disease. The rates of mortality, ICU admission and POF were 0.8%, 4.5% and 7.3%, respectively. FS24 showed a similar predictive accuracy in comparison with FS48 and was superior to FV24 in predicting ICU admission and POF. FS24 ≥ 1.6 L, male sex, presence of systemic inflammatory response syndrome and computed tomography severity index ≥ 3 on admission were independent risk factors for disease progression in AP in the multivariate analysis. FS24 was a simple and easily calculated parameter with high predictive accuracy for discriminating patients who needed intensive care. Patients with FS24 ≥ 1.6 L had an increased risk of developing severe disease.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Severity of Illness Index
law.invention
Young Adult
03 medical and health sciences
0302 clinical medicine
Risk Factors
law
Internal medicine
Intensive care
medicine
Humans
Risk factor
Aged
Retrospective Studies
Aged, 80 and over
Receiver operating characteristic
business.industry
Gastroenterology
Middle Aged
Hepatology
Prognosis
medicine.disease
Intensive care unit
Systemic inflammatory response syndrome
Intensive Care Units
Pancreatitis
030220 oncology & carcinogenesis
Acute Disease
Disease Progression
Fluid Therapy
Acute pancreatitis
Female
030211 gastroenterology & hepatology
business
Abdominal surgery
Subjects
Details
- ISSN :
- 14355922 and 09441174
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Journal of Gastroenterology
- Accession number :
- edsair.doi.dedup.....dc81afd4da194219369c4a5c303079b6