Prevalence of cardiovascular dysfunction and its association with outcome in patients with acute pancreatitis
| Autor: | Thakur Deen Yadav, Ajay Bahl, Narendra Dhaka, Rakesh Kochhar, Raghavendra Prasada |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Systole 030204 cardiovascular system & hematology Severity of Illness Index 03 medical and health sciences Electrocardiography Ventricular Dysfunction Left 0302 clinical medicine Internal medicine Severity of illness medicine Prevalence Creatine Kinase MB Form Humans Prospective Studies Prospective cohort study Depression (differential diagnoses) Heart Failure Ejection fraction business.industry Pancreatitis Acute Necrotizing Gastroenterology Acute kidney injury Stroke Volume Length of Stay Middle Aged medicine.disease Prognosis Respiratory failure Echocardiography Heart failure Cardiology Acute pancreatitis 030211 gastroenterology & hepatology Female business Tomography X-Ray Computed Biomarkers |
| Zdroj: | Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology. 37(2) |
| ISSN: | 0975-0711 |
| Popis: | Organ failure (OF) is the most important predictor of outcome in severe acute pancreatitis (SAP). Cardiovascular failure (CVSF) occurs in a variable proportion of patients with SAP. We aimed to study myocardial dysfunction in acute pancreatitis (AP) and its impact on the outcome. In this prospective study between January 2011 and July 2012, consecutive eligible patients of AP were enrolled. Myocardial function was assessed by measuring CK-MB (creatine phosphokinase isoenzyme) and echocardiography at admission. Electrocardiography (ECG) findings at admission were noted. Patients were managed in a high dependency unit using a step-up approach and followed up during hospital stay for their outcome. The outcome variables were computed tomography severity index (CTSI), the severity of AP, infection, need for intervention, length of hospital stay, and mortality. Of the 65 patients (mean age 39.55 ± 13.14 years; 67.7% males; etiology: alcohol 47.7%, gallstone disease 43.1%, and others 3%), 28 (43%) had organ failure. Respiratory failure was present in 21 (32.3%) patients, acute kidney injury (AKI) in 11 (16.9%) patients, and cardiovascular dysfunction was present in 4 (6.2%) patients. ECG changes were present in 26 (40%) patients with ST segment depression with T wave inversion being the most common (n = 22, 85%). Elevated CK-MB level (more than two times normal) was seen in 18 (27.7%) patients and was associated with increased necrosis (odds ratio = 2.44, 95% confidence interval = 0.5–12.3, p = 0.021), CTSI (7.7 ± 2.7 vs. 5.0 ± 3.0, p = 0.002), severity of AP (p = 0.05), CVSF (p = 0.005), hospital stay (19.3 ± 12.3 vs. 12.3 ± 7.0, p = 0.006), and mortality (odds ratio = 6.42, 95% confidence interval = 1.0–38.9, p = 0.045). Left ventricular systolic dysfunction (left ventricular ejection fraction [LVEF] |
| Databáze: | OpenAIRE |
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