Clinical outcomes of isolated renal failure compared to other forms of organ failure in patients with severe acute pancreatitis
AIM To assess differences in clinical outcomes of isolated renal failure(RF) compared to other forms of organ failure(OF) in patients with severe acute pancreatitis(SAP).METHODS Using a prospectively maintained database of patients with acute pancreatitis admitted to a tertiary medical center betwee...
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| Veröffentlicht in: | World journal of gastroenterology : WJG 2017-08, Vol.23 (29), p.5431-5437 |
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| container_title | World journal of gastroenterology : WJG |
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| creator | Gougol, Amir Dugum, Mohannad Dudekula, Anwar Greer, Phil Slivka, Adam Whitcomb, David C Yadav, Dhiraj Papachristou, Georgios I |
| description | AIM To assess differences in clinical outcomes of isolated renal failure(RF) compared to other forms of organ failure(OF) in patients with severe acute pancreatitis(SAP).METHODS Using a prospectively maintained database of patients with acute pancreatitis admitted to a tertiary medical center between 2003 and 2016, those with evidence of persistent OF were classified to renal, respiratory, cardiovascular, or multi-organ(2 or more organs). Data regarding demographics, comorbidities, etiology of acute pancreatitis, and clinical outcomes were prospectively recorded. Differences in clinical outcomes after development of isolated RF in comparison to other forms of OF were determined using independent t and Mann-Whitney U tests for continues variables, and χ~2 test for discrete variables.RESULTS Among 500 patients with acute pancreatitis, 111 patients developed persistent OF: mean age was 54 years, and 75(67.6%) were male. Forty-three patients had isolated OF: 17(15.3%) renal, 25(21.6%) respiratory, and 1(0.9%) patient with cardiovascular failure. No differences in demographics, etiology of acute pancreatitis, systemic inflammatory response syndrome scores, or development of pancreatic necrosis were seen between patients with isolated RF vs isolated respiratory failure. Patients with isolated RF were less likely to require nutritional support(76.5% vs 96%, P = 0.001), ICU admission(58.8% vs 100%, P = 0.001), and had shorter mean ICU stay(2.4 d vs 15.7 d, P < 0.001), compared to isolated respiratory failure. None of the patients with isolated RF or isolated respiratory failure died.CONCLUSION Among patients with SAP per the Revised Atlanta Classification, approximately 15% develop isolated RF. This subgroup seems to have a less protracted clinical course compared to other forms of OF. Isolated RF might be weighed less than isolated respiratory failure in risk predictive modeling of acute pancreatitis. |
| doi_str_mv | 10.3748/wjg.v23.i29.5431 |
| format | Article |
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Data regarding demographics, comorbidities, etiology of acute pancreatitis, and clinical outcomes were prospectively recorded. Differences in clinical outcomes after development of isolated RF in comparison to other forms of OF were determined using independent t and Mann-Whitney U tests for continues variables, and χ~2 test for discrete variables.RESULTS Among 500 patients with acute pancreatitis, 111 patients developed persistent OF: mean age was 54 years, and 75(67.6%) were male. Forty-three patients had isolated OF: 17(15.3%) renal, 25(21.6%) respiratory, and 1(0.9%) patient with cardiovascular failure. No differences in demographics, etiology of acute pancreatitis, systemic inflammatory response syndrome scores, or development of pancreatic necrosis were seen between patients with isolated RF vs isolated respiratory failure. Patients with isolated RF were less likely to require nutritional support(76.5% vs 96%, P = 0.001), ICU admission(58.8% vs 100%, P = 0.001), and had shorter mean ICU stay(2.4 d vs 15.7 d, P &lt; 0.001), compared to isolated respiratory failure. None of the patients with isolated RF or isolated respiratory failure died.CONCLUSION Among patients with SAP per the Revised Atlanta Classification, approximately 15% develop isolated RF. This subgroup seems to have a less protracted clinical course compared to other forms of OF. Isolated RF might be weighed less than isolated respiratory failure in risk predictive modeling of acute pancreatitis.</description><identifier>ISSN: 1007-9327</identifier><identifier>EISSN: 2219-2840</identifier><identifier>DOI: 10.3748/wjg.v23.i29.5431</identifier><identifier>PMID: 28839444</identifier><language>eng</language><publisher>United States: Baishideng Publishing Group Inc</publisher><subject>Adult ; Aged ; APACHE ; Comorbidity ; Female ; Humans ; Intensive Care Units - statistics & numerical data ; Length of Stay ; Male ; Middle Aged ; Multiple Organ Failure - epidemiology ; Multiple Organ Failure - etiology ; Necrosis - epidemiology ; Nutritional Support - statistics & numerical data ; Pancreas - pathology ; Pancreatitis - complications ; Prognosis ; Prospective Studies ; Prospective Study ; Renal Insufficiency - epidemiology ; Renal Insufficiency - etiology ; Respiratory Insufficiency - epidemiology ; Respiratory Insufficiency - etiology ; Risk Assessment - methods ; Tertiary Care Centers - statistics & numerical data</subject><ispartof>World journal of gastroenterology : WJG, 2017-08, Vol.23 (29), p.5431-5437</ispartof><rights>The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. 2017</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-8c0e5894c40bd0fd2c864236abbb87ffb6c57b5fe2d4f753f660a40cdbfa10d3</citedby><cites>FETCH-LOGICAL-c440t-8c0e5894c40bd0fd2c864236abbb87ffb6c57b5fe2d4f753f660a40cdbfa10d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://image.cqvip.com/vip1000/qk/84123X/84123X.jpg</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550793/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550793/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28839444$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gougol, Amir</creatorcontrib><creatorcontrib>Dugum, Mohannad</creatorcontrib><creatorcontrib>Dudekula, Anwar</creatorcontrib><creatorcontrib>Greer, Phil</creatorcontrib><creatorcontrib>Slivka, Adam</creatorcontrib><creatorcontrib>Whitcomb, David C</creatorcontrib><creatorcontrib>Yadav, Dhiraj</creatorcontrib><creatorcontrib>Papachristou, Georgios I</creatorcontrib><title>Clinical outcomes of isolated renal failure compared to other forms of organ failure in patients with severe acute pancreatitis</title><title>World journal of gastroenterology : WJG</title><addtitle>World Journal of Gastroenterology</addtitle><description>AIM To assess differences in clinical outcomes of isolated renal failure(RF) compared to other forms of organ failure(OF) in patients with severe acute pancreatitis(SAP).METHODS Using a prospectively maintained database of patients with acute pancreatitis admitted to a tertiary medical center between 2003 and 2016, those with evidence of persistent OF were classified to renal, respiratory, cardiovascular, or multi-organ(2 or more organs). Data regarding demographics, comorbidities, etiology of acute pancreatitis, and clinical outcomes were prospectively recorded. Differences in clinical outcomes after development of isolated RF in comparison to other forms of OF were determined using independent t and Mann-Whitney U tests for continues variables, and χ~2 test for discrete variables.RESULTS Among 500 patients with acute pancreatitis, 111 patients developed persistent OF: mean age was 54 years, and 75(67.6%) were male. Forty-three patients had isolated OF: 17(15.3%) renal, 25(21.6%) respiratory, and 1(0.9%) patient with cardiovascular failure. No differences in demographics, etiology of acute pancreatitis, systemic inflammatory response syndrome scores, or development of pancreatic necrosis were seen between patients with isolated RF vs isolated respiratory failure. Patients with isolated RF were less likely to require nutritional support(76.5% vs 96%, P = 0.001), ICU admission(58.8% vs 100%, P = 0.001), and had shorter mean ICU stay(2.4 d vs 15.7 d, P &lt; 0.001), compared to isolated respiratory failure. None of the patients with isolated RF or isolated respiratory failure died.CONCLUSION Among patients with SAP per the Revised Atlanta Classification, approximately 15% develop isolated RF. This subgroup seems to have a less protracted clinical course compared to other forms of OF. Isolated RF might be weighed less than isolated respiratory failure in risk predictive modeling of acute pancreatitis.</description><subject>Adult</subject><subject>Aged</subject><subject>APACHE</subject><subject>Comorbidity</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multiple Organ Failure - epidemiology</subject><subject>Multiple Organ Failure - etiology</subject><subject>Necrosis - epidemiology</subject><subject>Nutritional Support - statistics & numerical data</subject><subject>Pancreas - pathology</subject><subject>Pancreatitis - complications</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Prospective Study</subject><subject>Renal Insufficiency - epidemiology</subject><subject>Renal Insufficiency - etiology</subject><subject>Respiratory Insufficiency - epidemiology</subject><subject>Respiratory Insufficiency - etiology</subject><subject>Risk Assessment - methods</subject><subject>Tertiary Care Centers - statistics & numerical data</subject><issn>1007-9327</issn><issn>2219-2840</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUctu1DAUtRAVnRb2rJCXbDLc-JE4GyQ0ogWpEpvuLcexM64Se2o7U7Hi1-u0wwi8sXzP4x75IPSxhi1tmfjy9DBuj4RuHem2nNH6DdoQUncVEQzeok0N0FYdJe0lukrpAYBQysk7dEmEoB1jbIP-7CbnnVYTDkvWYTYJB4tdCpPKZsDR-AJZ5aYlGlzwg4plnAMOeW8itiHOL4oQR-XPROfxQWVnfE74yeU9TuZoylzpJZsCeR1NwbNL79GFVVMyH073Nbq_-X6_-1Hd_br9uft2V2nGIFdCg-GiY5pBP4AdiBYNI7RRfd-L1tq-0bztuTVkYLbl1DYNKAZ66K2qYaDX6Our7WHpZzPokiyqSR6im1X8LYNy8n_Eu70cw1FyzqHtaDH4fDKI4XExKcvZJW2mSXkTliTr8s2CNbyGQoVXqo4hpWjseU0Ncq1NltpkqU2W2uRaW5F8-jfeWfC3p0KgJ8998OOj8-OZ04FYT8eBCdateXnZsb7oMym4qMY</recordid><startdate>20170807</startdate><enddate>20170807</enddate><creator>Gougol, Amir</creator><creator>Dugum, Mohannad</creator><creator>Dudekula, Anwar</creator><creator>Greer, Phil</creator><creator>Slivka, Adam</creator><creator>Whitcomb, David C</creator><creator>Yadav, Dhiraj</creator><creator>Papachristou, Georgios I</creator><general>Baishideng Publishing Group Inc</general><scope>2RA</scope><scope>92L</scope><scope>CQIGP</scope><scope>~WA</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170807</creationdate><title>Clinical outcomes of isolated renal failure compared to other forms of organ failure in patients with severe acute pancreatitis</title><author>Gougol, Amir ; Dugum, Mohannad ; Dudekula, Anwar ; Greer, Phil ; Slivka, Adam ; Whitcomb, David C ; Yadav, Dhiraj ; Papachristou, Georgios I</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-8c0e5894c40bd0fd2c864236abbb87ffb6c57b5fe2d4f753f660a40cdbfa10d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>APACHE</topic><topic>Comorbidity</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multiple Organ Failure - epidemiology</topic><topic>Multiple Organ Failure - etiology</topic><topic>Necrosis - epidemiology</topic><topic>Nutritional Support - statistics & numerical data</topic><topic>Pancreas - pathology</topic><topic>Pancreatitis - complications</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Prospective Study</topic><topic>Renal Insufficiency - epidemiology</topic><topic>Renal Insufficiency - etiology</topic><topic>Respiratory Insufficiency - epidemiology</topic><topic>Respiratory Insufficiency - etiology</topic><topic>Risk Assessment - methods</topic><topic>Tertiary Care Centers - statistics & numerical data</topic><toplevel>online_resources</toplevel><creatorcontrib>Gougol, Amir</creatorcontrib><creatorcontrib>Dugum, Mohannad</creatorcontrib><creatorcontrib>Dudekula, Anwar</creatorcontrib><creatorcontrib>Greer, Phil</creatorcontrib><creatorcontrib>Slivka, Adam</creatorcontrib><creatorcontrib>Whitcomb, David C</creatorcontrib><creatorcontrib>Yadav, Dhiraj</creatorcontrib><creatorcontrib>Papachristou, Georgios I</creatorcontrib><collection>中文科技期刊数据库</collection><collection>中文科技期刊数据库-CALIS站点</collection><collection>中文科技期刊数据库-7.0平台</collection><collection>中文科技期刊数据库- 镜像站点</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of gastroenterology : WJG</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gougol, Amir</au><au>Dugum, Mohannad</au><au>Dudekula, Anwar</au><au>Greer, Phil</au><au>Slivka, Adam</au><au>Whitcomb, David C</au><au>Yadav, Dhiraj</au><au>Papachristou, Georgios I</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcomes of isolated renal failure compared to other forms of organ failure in patients with severe acute pancreatitis</atitle><jtitle>World journal of gastroenterology : WJG</jtitle><addtitle>World Journal of Gastroenterology</addtitle><date>2017-08-07</date><risdate>2017</risdate><volume>23</volume><issue>29</issue><spage>5431</spage><epage>5437</epage><pages>5431-5437</pages><issn>1007-9327</issn><eissn>2219-2840</eissn><abstract>AIM To assess differences in clinical outcomes of isolated renal failure(RF) compared to other forms of organ failure(OF) in patients with severe acute pancreatitis(SAP).METHODS Using a prospectively maintained database of patients with acute pancreatitis admitted to a tertiary medical center between 2003 and 2016, those with evidence of persistent OF were classified to renal, respiratory, cardiovascular, or multi-organ(2 or more organs). Data regarding demographics, comorbidities, etiology of acute pancreatitis, and clinical outcomes were prospectively recorded. Differences in clinical outcomes after development of isolated RF in comparison to other forms of OF were determined using independent t and Mann-Whitney U tests for continues variables, and χ~2 test for discrete variables.RESULTS Among 500 patients with acute pancreatitis, 111 patients developed persistent OF: mean age was 54 years, and 75(67.6%) were male. Forty-three patients had isolated OF: 17(15.3%) renal, 25(21.6%) respiratory, and 1(0.9%) patient with cardiovascular failure. No differences in demographics, etiology of acute pancreatitis, systemic inflammatory response syndrome scores, or development of pancreatic necrosis were seen between patients with isolated RF vs isolated respiratory failure. Patients with isolated RF were less likely to require nutritional support(76.5% vs 96%, P = 0.001), ICU admission(58.8% vs 100%, P = 0.001), and had shorter mean ICU stay(2.4 d vs 15.7 d, P &lt; 0.001), compared to isolated respiratory failure. None of the patients with isolated RF or isolated respiratory failure died.CONCLUSION Among patients with SAP per the Revised Atlanta Classification, approximately 15% develop isolated RF. This subgroup seems to have a less protracted clinical course compared to other forms of OF. Isolated RF might be weighed less than isolated respiratory failure in risk predictive modeling of acute pancreatitis.</abstract><cop>United States</cop><pub>Baishideng Publishing Group Inc</pub><pmid>28839444</pmid><doi>10.3748/wjg.v23.i29.5431</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged APACHE Comorbidity Female Humans Intensive Care Units - statistics & numerical data Length of Stay Male Middle Aged Multiple Organ Failure - epidemiology Multiple Organ Failure - etiology Necrosis - epidemiology Nutritional Support - statistics & numerical data Pancreas - pathology Pancreatitis - complications Prognosis Prospective Studies Prospective Study Renal Insufficiency - epidemiology Renal Insufficiency - etiology Respiratory Insufficiency - epidemiology Respiratory Insufficiency - etiology Risk Assessment - methods Tertiary Care Centers - statistics & numerical data |
| title | Clinical outcomes of isolated renal failure compared to other forms of organ failure in patients with severe acute pancreatitis |
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