PancRea: Risk Factors and Outcomes of Infected Pancreatic Necrosis

Watumiaji waliosajiliwa tu ndio wanaweza kutafsiri nakala

Ingia / Ingia

Kiungo kimehifadhiwa kwenye clipboard

HaliImekamilika

Wadhamini

Nantes University Hospital

JARIBIO LA KLINIKI: NCT03253861

BioSeek: nct03253861

Maneno muhimu

non-alcoholic fatty liver disease

Kikemikali

Severe acute pancreatitis is a common reason for intensive care unit (ICU) admission and is associated with prolonged hospital stays and high morbidity and mortality rates. The Atlanta classification differentiates mild, moderate, and severe acute pancreatitis, and each of these categories correlates with morbidity and mortality. Mortality remains high, between 10% and 39%, in severe and moderately severe acute pancreatitis. After the first week, about 30% of patients with necrotizing pancreatitis develop infected pancreatic necrosis (IPN). IPN is a risk factor for mortality.The treatment of IPN combines antibiotics with interventions to remove the infected intra-abdominal material, preferably using minimally invasive techniques such as percutaneous and endoscopic drainage, which have been proven beneficial. In several studies biological markers such as procalcitonin and interleukin 8 were effective in predicting IPN. However, few clinical risk factors for IPN have been reported. Identifying risk factors may help to improve standardized strategies for early diagnosis and treatment, and then patients outcome. Our primary objective was to identify risk factors for IPN in patients admitted to the ICU for acute pancreatitis. Our secondary objective was to describe the management and outcomes of IPN

Maelezo

Using electronic patient data monitoring systems, the investigators reviewed all patients with a diagnosis of acute necrotizing pancreatitis admitted to digestive liver disease unity or ICUs at the Nantes University Hospital, from January 1, 2012, to december 31, 2015. For enrolled patients, general clinical characteristics were collected. Patients were categorized into two groups according to the development of an infected pancreatic necrosis (highly suspected or proven), and the differences of these characteristics between two groups were evaluated. Potential risk factors were collected and studied by using multiple logistic regression analysis.

Tarehe

Imethibitishwa Mwisho:	07/31/2017
Iliyowasilishwa Kwanza:	08/15/2017
Uandikishaji uliokadiriwa Uliwasilishwa:	08/15/2017
Iliyotumwa Kwanza:	08/17/2017
Sasisho la Mwisho Liliwasilishwa:	08/15/2017
Sasisho la Mwisho Lilichapishwa:	08/17/2017
Tarehe halisi ya kuanza kwa masomo:	05/31/2016
Tarehe ya Kukamilisha Msingi iliyokadiriwa:	12/31/2016
Tarehe ya Kukamilisha Utafiti:	05/31/2017

Hali au ugonjwa

Acute Necrotizing Pancreatitis

Infection

Pancreatitis

Uingiliaji / matibabu

Other: No intervention

Awamu

Vikundi vya Arm

Mkono	Uingiliaji / matibabu
control patients patients without an infected pancreatic necrosis
Case patients patients with an infected pancreatic necrosis

Vigezo vya Kustahiki

Zama zinazostahiki Kujifunza	18 Years Kwa 18 Years
Jinsia Inastahiki Kujifunza	All
Njia ya sampuli	Non-Probability Sample
Hupokea Wajitolea wa Afya	Ndio
Vigezo	Inclusion Criteria: - Adult patients (age >18 years) with acute necrotizing pancreatitis admitted in an ICU between January 2012 and December 2015 for moderately severe or severe acute pancreatitis were included. - Organ failure that resolves within 48 h (transient organ failure) and/or local or systemic complications without persistent organ failure or persistent organ failure (>48 h) Exclusion Criteria: - mild acute pancreatitis, defined as no organ failure or local complication (No necrosis or peri-pancreatic collection)

Matokeo

Hatua za Matokeo ya Msingi

1. Risk factors of infected pancreatic necrosis [4 months]

Potential risk factors included patient demographics, disease severity, complications, morphology on CT, and details of the drainage procedure. Univariate analyses examined potential risk factors on outcome (catheter drainage failure). Then, using multiple logistic regression analysis, factors achieving P≤0.1 in univariate analyses were entered into the model predicting the risk of catheter drainage failure

Hatua za Matokeo ya Sekondari

1. Risk factors of mortality [4 months]

Potential risk factors included patient demographics, disease severity, complications, morphology on CT, and details of the drainage procedure. Univariate analyses examined potential risk factors on outcome (mortality). Then, using multiple logistic regression analysis, factors achieving P≤0.1 in univariate analyses were entered into the model predicting the risk of non-survival