| Autor: |
Umapathy, Chandraprakash, Raina, Amit, Saligram, Shreyas, Tang, Gong, Papachristou, Georgios, Rabinovitz, Mordechai, Chennat, Jennifer, Zeh, Herbert, Zureikat, Amer, Hogg, Melissa, Lee, Kenneth, Saul, Melissa, Whitcomb, David, Slivka, Adam, Yadav, Dhiraj, Papachristou, Georgios I, Zureikat, Amer H, Hogg, Melissa E, Lee, Kenneth K, Saul, Melissa I |
| Předmět: |
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| Zdroj: |
Journal of Gastrointestinal Surgery; Nov2016, Vol. 20 Issue 11, p1844-1853, 10p |
| Abstrakt: |
Background: Most studies of acute necrotizing pancreatitis (ANP) focus on short-term outcomes. We evaluated long-term survival and outcomes following ANP.Methods: Patients treated for ANP at the University of Pittsburgh Medical Center from 2001 to 2008 were studied. Data on presentation and course during initial hospitalization and follow-up (median 34 months) was extracted.Results: Mean age of patients (n = 167) was 53 ± 16 years; 70 % were male, 94 % white, 71 % transfers, 52 % biliary etiology, and 78 % had first-attack of acute pancreatitis. Majority had severe disease with high Acute Physiology and Chronic Health Evaluation II (APACHE-II) score (median 11), length of stay (median 26 days), intensive care unit (ICU) admission (87 %), presence of systemic inflammatory response syndrome (SIRS) (90 %), persistent organ failure (60 %), and infected necrosis (50 %). Intervention was needed in 74 %. Eighteen (10.8 %) patients died during index hospitalization, 9 (5.4 %) during the first year, and 13 (7.8 %) after 1 year. Median survival was significantly shorter when compared with age- and sex-matched US general population (9.1 vs. 26.1 years, p < 0.001). Increasing age (HR 1.05), persistent organ failure (HR 4.5), and >50 % necrosis (HR 3.8) were independent predictors of death at 1 year. In eligible patients, new-onset diabetes, oral pancreatic enzyme replacement therapy, and disability were noted in 45, 25, and 53 %, respectively.Conclusion: ANP significantly impacts long-term survival. A high proportion of patients develop functional derangement and disability following ANP. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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