Early Predictors of Fluid Sequestration in Acute Pancreatitis A Validation Study
Por:
Sinha, A, Vazquez, N, Faghih, M, Afghani, E, Zaheer, A, Khashab, M, Lennon, A, de-Madaria, E and Singh, V
Publicada:
1 feb 2016
Resumen:
Objectives The primary aim of this retrospective study was to externally validate predictors of increased fluid sequestration at 48 hours (FS48) in acute pancreatitis (AP).
Methods Patients admitted between January 10 and February 13 with a diagnosis of AP were evaluated. The FS48 was calculated as difference between total fluid input and output in the first 48 hours. Predictors of FS48, such as young age, alcoholic etiology, hemoconcentration, hyperglycemia, and systemic inflammatory response syndrome (SIRS), and outcomes in AP, such as increased length of stay, acute fluid collection(s), necrosis, and persistent organ failure (POF), were defined in accordance with the previous study. Linear regression analysis was performed to evaluate the association between predictors and outcome.
Results Two hundred twenty-seven AP patients (mean age, 48 years; 54% men) with a median FS48 of 4.2 L were evaluated. Age younger than 40 years, alcoholic etiology, hemoconcentration, and SIRS independently predicted increased FS48 (P < 0.05). Increased FS48 was associated with persistent SIRS and POF (P < 0.01). There was a significant trend between number of predictors and FS48 (P < 0.001). The presence of 4 predictors or more was associated with higher rates of persistent SIRS and POF (P < 0.01).
Conclusions Our study validated 4 of 5 predictors of increased FS48 from the previous study. Presence of 4 predictors or more and increased FS48 are both associated with persistent SIRS and POF.
Filiaciones:
Sinha, A:
Johns Hopkins Med Inst, Div Gastroenterol, Baltimore, MD 21205 USA
:
Hosp Gen Univ Alicante, Pancreat Unit, Alicante, Spain
Faghih, M:
Johns Hopkins Med Inst, Div Gastroenterol, Baltimore, MD 21205 USA
Afghani, E:
Johns Hopkins Med Inst, Div Gastroenterol, Baltimore, MD 21205 USA
Zaheer, A:
Johns Hopkins Med Inst, Dept Radiol & Radiol Sci, 600 N Wolfe St, Baltimore, MD 21205 USA
Johns Hopkins Med Inst, Pancreatitis Ctr, Baltimore, MD 21205 USA
Khashab, M:
Johns Hopkins Med Inst, Div Gastroenterol, Baltimore, MD 21205 USA
Lennon, A:
Johns Hopkins Med Inst, Div Gastroenterol, Baltimore, MD 21205 USA
:
Hosp Gen Univ Alicante, Pancreat Unit, Alicante, Spain
Singh, V:
Johns Hopkins Med Inst, Div Gastroenterol, Baltimore, MD 21205 USA
Johns Hopkins Med Inst, Pancreatitis Ctr, Baltimore, MD 21205 USA
|