International multidisciplinary survey on the initial management of acute pancreatitis: Perspective of point-of-care specialists focused on daily practice.
Por:
Lluís N, Asbun H, Besselink MG, Capurso G, Garg PK, Gelrud A, Khannoussi W, Lee HS, Leppäniemi A, Löhr JM, Mahapatra SJ, Mancilla C, van Santvoort HC, Zapater P, Lluís F, de Madaria E and Ramia JM
Publicada:
1 mar 2023
Ahead of Print:
18 jun 2022
Resumen:
BACKGROUND: The initial management of patients with acute pancreatitis impacts both morbidity and mortality. Point-of-care decisions have been reported to differ from clinical guideline recommendations. METHODS: An online anonymous questionnaire was distributed through scientific associations and social media using REDCap. Multivariable logistic regression was used to identify the characteristics of participants associated with compliance with the recommendations. RESULTS: A total of 1054 participants from 94 countries completed the questionnaire; median age (IQR) was 39 (32-47) years; 30.7% were women. Among the participants, 37% opted for nonmoderate flow of i.v. fluid, 31% for fluid type other than Ringer's lactate; 73.4% were in favor of nil per os to patients who could eat, 75.5% for other than enteral feeding to patients with oral intolerance; 15.5% used prophylactic antibiotic in patients with severe acute pancreatitis, 34.1% in necrotizing acute pancreatitis, and 27.4% in patients with systemic inflammatory response syndrome; 27.8% delayed cholecystectomy after biliary acute pancreatitis. Participants with publications in PubMed on acute pancreatitis showed better compliance (OR, 1.62; 95% CI: 1.15-2.32; P = .007) with recommendations of the clinical guidelines. CONCLUSIONS: Feeding and nutrition require the greatest improvement efforts, but also the use of prophylactic antibiotics and timing of cholecystectomy should be improved.
Filiaciones:
Lluís N:
Division of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, Florida, USA
Asbun H:
Division of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, Florida, USA
Besselink MG:
Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
Capurso G:
Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy
Garg PK:
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
Gelrud A:
Pancreatic Disease Center, Interventional Endoscopy, Miami Cancer Institute, Gastro Health, Miami, Florida, USA
Khannoussi W:
Hepato-Gastroenterology Department, Mohammed VI University Hospital, Oujda, Morocco
Laboratoire de Recherche des Maladies Digestives (LARMAD), Mohammed The First University, Oujda, Morocco
Lee HS:
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
Leppäniemi A:
Department of Surgery, Helsinki University Hospital, Helsinki, Finland
Löhr JM:
Gastrocentrum, Karolinska Institutet and University Hospital, Stockholm, Sweden
Mahapatra SJ:
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
Mancilla C:
Gastroenterology Section and Critical Care Unit, University of Chile Clinical Hospital, Santiago, Chile
van Santvoort HC:
Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands
:
Health and Biomedical Research Institute of Alicante (ISABIAL), Alicante, Spain
CIBEREHD, Instituto de Salud Carlos III, Madrid, Spain
:
Health and Biomedical Research Institute of Alicante (ISABIAL), Alicante, Spain
:
Health and Biomedical Research Institute of Alicante (ISABIAL), Alicante, Spain
Department of Gastroenterology, General University Hospital of Alicante, Alicante, Spain
:
Health and Biomedical Research Institute of Alicante (ISABIAL), Alicante, Spain
Department of Surgery, General University Hospital of Alicante, Alicante, Spain
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