Adherence to Guidelines Influenced the Mortality, Hospital Stay, and Health Care System Costs in Patients With Acute Pancreatitis
| Autor: | Claudio Ricci, Carlo Ingaldi, Laura Alberici, Giovanni Marasco, Nico Pagano, Cristina Mosconi, Marina Migliori, Carla Serra, Ida Davidovich, Giacomo Sermonesi, Luigina Vanessa Alemanni, Benedetta Rossini, Claudio Isopi, Riccardo Casadei |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Pancreas. 51:943-949 |
| ISSN: | 1536-4828 0885-3177 |
| Popis: | The primary end point was the compliance rate with guidelines. The secondaries were mortality, hospital stay, and costs.This study included 1904 patients with acute pancreatitis (AP): group A, diagnosed before 2013, and group B, after 2013.The compliance rate was 0.6%. The compliance rates increased for fluid resuscitation (3.3% vs 13.7%, P0.001), for antibiotics use (21.9% vs 28.1%, P = 0.002), for oral feeding (55.0% vs 49.7%, P = 0.007), and for correct use of endoscopic retrograde cholangiopancreatography (ERCP) (83% vs 91.9%, P0.001). Compliance to severity assessment with computed tomography (odds ratio [OR], 0.4; P = 0.029), parenteral nutrition recommendations (OR, 0.3; P = 0.009), and early surgery (OR, 0.3; P = 0.010) reduced the mortality. Compliance to antibiotic therapy (OR, 0.6; P0.001), correct use of parenteral nutrition (OR, 0.3; P0.001), correct use of ERCP (OR, 0.5; P0.001), and early surgery (OR, 0.3; P = 0.010) reduced hospital stay. The compliance reduced the costs for parenteral nutrition (P0.001), correct use of ERCP (P = 0.011), and surgery (P = 0.010).The adherence to guidelines for AP was low. Compliance could reduce mortality, prolonged hospital stay, and costs. |
| Databáze: | OpenAIRE |
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