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Determinants of Sev...
Determinants of Severity in Acute Pancreatitis : A Nation-wide Multicenter Prospective Cohort Study
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- Sternby, Hanna (author)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups
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- Bolado, Federico (author)
- University of Navarra
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- Canaval-Zuleta, Héctor J. (author)
- Hospital Son Llàtzer
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- Marra-López, Carlos (author)
- Hospital Universitario Araba
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- Hernando-Alonso, Ana I. (author)
- Hospital Universitario Quirón
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- Del-Val-Antoñana, Adolfo (author)
- University and Polytechnic Hospital la Fe
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- García-Rayado, Guillermo (author)
- Aragon Health Sciences Institute
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- Rivera-Irigoin, Robin (author)
- Hospital Costa del Sol
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- Grau-García, Francisco J. (author)
- Hospital Arnau de Vilanova in Valencia
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- Oms, Lluís (author)
- Consorci Sanitari de Terrassa
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- Millastre-Bocos, Judith (author)
- Miguel Servet University Hospital
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- Pascual-Moreno, Isabel (author)
- University and Polytechnic Hospital la Fe
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- Martínez-Ares, David (author)
- Hospital Meixoeiro
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- Rodríguez-Oballe, Juan A. (author)
- University Hospital Virgen Macarena
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- López-Serrano, Antonio (author)
- Hospital Universitario Doctor Peset
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- Ruiz-Rebollo, María L. (author)
- University of Valladolid
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- Viejo-Almanzor, Alejandro (author)
- Puerta del Mar University Hospital
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- González-de-la-Higuera, Belén (author)
- University of Navarra
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- Orive-Calzada, Aitor (author)
- Hospital Universitario Araba
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- Gómez-Anta, Ignacio (author)
- Hospital Universitario Quirón
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- Pamies-Guilabert, José (author)
- University and Polytechnic Hospital la Fe
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- Fernández-Gutiérrez-Del-Álamo, Fátima (author)
- Hospital Costa del Sol
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- Iranzo-González-Cruz, Isabel (author)
- Hospital Arnau de Vilanova in Valencia
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- Pérez-Muñante, Mónica E. (author)
- Autonomous University of Barcelona
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- Esteba, María D. (author)
- Autonomous University of Barcelona
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- Pardillos-Tomé, Ana (author)
- Miguel Servet University Hospital
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- Zapater, Pedro (author)
- University of Alicante
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- de-Madaria, Enrique (author)
- University of Alicante
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(creator_code:org_t)
- 2019
- 2019
- English.
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In: Annals of Surgery. - 1528-1140. ; 270:2, s. 348-355
- Related links:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
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- OBJECTIVE: The aim of this study was to compare and validate the different classifications of severity in acute pancreatitis (AP) and to investigate which characteristics of the disease are associated with worse outcomes. SUMMARY OF BACKGROUND DATA: AP is a heterogeneous disease, ranging from uneventful cases to patients with considerable morbidity and high mortality rates. Severity classifications based on legitimate determinants of severity are important to correctly describe the course of disease. METHODS: A prospective multicenter cohort study involving patients with AP from 23 hospitals in Spain. The Atlanta Classification (AC), Revised Atlanta Classification (RAC), and Determinant-based Classification (DBC) were compared. Binary logistic multivariate analysis was performed to investigate independent determinants of severity. RESULTS: A total of 1655 patients were included; 70 patients (4.2%) died. RAC and DBC were equally superior to AC for describing the clinical course of AP. Although any kind of organ failure was associated with increased morbidity and mortality, persistent organ failure (POF) was the most significant determinant of severity. All local complications were associated with worse outcomes. Infected pancreatic necrosis correlated with high morbidity, but in the presence of POF, it was not associated to higher mortality when compared with sterile necrotizing pancreatitis. Exacerbation of previous comorbidity was associated with increased morbidity and mortality. CONCLUSION: The RAC and DBC both signify an advance in the description and differentiation of AP patients. Herein, we describe the complications of the disease independently associated to morbidity and mortality. Our findings are valuable not only when designing future studies on AP but also for the improvement of current classifications.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Keyword
- surgery
- acute pancreatitis
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Sternby, Hanna
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Bolado, Federico
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Canaval-Zuleta, ...
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Marra-López, Car ...
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Hernando-Alonso, ...
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Del-Val-Antoñana ...
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García-Rayado, G ...
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Rivera-Irigoin, ...
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Grau-García, Fra ...
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Oms, Lluís
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Millastre-Bocos, ...
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Pascual-Moreno, ...
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Martínez-Ares, D ...
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Rodríguez-Oballe ...
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López-Serrano, A ...
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Ruiz-Rebollo, Ma ...
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Viejo-Almanzor, ...
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González-de-la-H ...
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Orive-Calzada, A ...
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Gómez-Anta, Igna ...
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Pamies-Guilabert ...
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Fernández-Gutiér ...
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Iranzo-González- ...
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Pérez-Muñante, M ...
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Esteba, María D.
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Pardillos-Tomé, ...
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Zapater, Pedro
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de-Madaria, Enri ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Gastroenterology ...
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Annals of Surger ...
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Lund University