S. Anikhindi, Ashish Kumar, Vikas Singla, Praveen Sharma, N. Bansal, N. Verma, A. Arora
{"title":"修订的亚特兰大分类是急性胰腺炎患者死亡率的最强预测因子:一项对358例患者的研究","authors":"S. Anikhindi, Ashish Kumar, Vikas Singla, Praveen Sharma, N. Bansal, N. Verma, A. Arora","doi":"10.7869/TG.555","DOIUrl":null,"url":null,"abstract":"Background: Acute Pancreatitis (AP) presents with a wide range of severity and has varying outcomes. We report our experience with 358 consecutive patients with AP admitted to a tertiary care centre in North India for two years. Methods: In this retrospective study, clinical, biochemical, radiological, and treatment-related data of patients admitted with AP was collected and analysed. Predictors of 120-day mortality and treatment outcomes were analysed. Results: 358 patients (median age 42 years, 78% males) were included. The most common aetiology was biliary (37%) and alcohol (32%). Sixty-nine percent of patients had severe disease at admission according to the revised Atlanta classification. A total of 81 of 358 patients (23%) died within 120 days, with most of the deaths occurring within the first month of illness. A significant proportion of patients having severe AP (74/248, 29.8%) succumbed to illness, while only 6.4% (7/110) patients with mild or moderately severe AP had mortality within 120 days. On multivariate (Cox regression) analysis, the independent factors predicting 120-day mortality were: CT severity index >5 (OR 4.4), presence of respiratory failure (OR 14.9), presence of circulatory failure (OR 4.4), and severe pancreatitis on admission according to revised Atlanta classification (OR 56.4). Conclusions: Biliary and alcohol are the most common aetiologies of acute pancreatitis in north India. Acute pancreatitis still carries a poor outcome with a 23% mortality rate. Patients having severe pancreatitis at admission, according to revised Atlanta classification, are at the highest risk for mortality and should receive intensive care..","PeriodicalId":23281,"journal":{"name":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","volume":"31 1","pages":"137-150"},"PeriodicalIF":0.0000,"publicationDate":"2020-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"The Revised Atlanta Classification is the Strongest Predictor of Mortality in Patients with Acute Pancreatitis: A Study on 358 Patients\",\"authors\":\"S. Anikhindi, Ashish Kumar, Vikas Singla, Praveen Sharma, N. Bansal, N. Verma, A. Arora\",\"doi\":\"10.7869/TG.555\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Acute Pancreatitis (AP) presents with a wide range of severity and has varying outcomes. We report our experience with 358 consecutive patients with AP admitted to a tertiary care centre in North India for two years. Methods: In this retrospective study, clinical, biochemical, radiological, and treatment-related data of patients admitted with AP was collected and analysed. Predictors of 120-day mortality and treatment outcomes were analysed. Results: 358 patients (median age 42 years, 78% males) were included. The most common aetiology was biliary (37%) and alcohol (32%). Sixty-nine percent of patients had severe disease at admission according to the revised Atlanta classification. A total of 81 of 358 patients (23%) died within 120 days, with most of the deaths occurring within the first month of illness. A significant proportion of patients having severe AP (74/248, 29.8%) succumbed to illness, while only 6.4% (7/110) patients with mild or moderately severe AP had mortality within 120 days. On multivariate (Cox regression) analysis, the independent factors predicting 120-day mortality were: CT severity index >5 (OR 4.4), presence of respiratory failure (OR 14.9), presence of circulatory failure (OR 4.4), and severe pancreatitis on admission according to revised Atlanta classification (OR 56.4). Conclusions: Biliary and alcohol are the most common aetiologies of acute pancreatitis in north India. Acute pancreatitis still carries a poor outcome with a 23% mortality rate. Patients having severe pancreatitis at admission, according to revised Atlanta classification, are at the highest risk for mortality and should receive intensive care..\",\"PeriodicalId\":23281,\"journal\":{\"name\":\"Tropical gastroenterology : official journal of the Digestive Diseases Foundation\",\"volume\":\"31 1\",\"pages\":\"137-150\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-06-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tropical gastroenterology : official journal of the Digestive Diseases Foundation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.7869/TG.555\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tropical gastroenterology : official journal of the Digestive Diseases Foundation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7869/TG.555","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
The Revised Atlanta Classification is the Strongest Predictor of Mortality in Patients with Acute Pancreatitis: A Study on 358 Patients
Background: Acute Pancreatitis (AP) presents with a wide range of severity and has varying outcomes. We report our experience with 358 consecutive patients with AP admitted to a tertiary care centre in North India for two years. Methods: In this retrospective study, clinical, biochemical, radiological, and treatment-related data of patients admitted with AP was collected and analysed. Predictors of 120-day mortality and treatment outcomes were analysed. Results: 358 patients (median age 42 years, 78% males) were included. The most common aetiology was biliary (37%) and alcohol (32%). Sixty-nine percent of patients had severe disease at admission according to the revised Atlanta classification. A total of 81 of 358 patients (23%) died within 120 days, with most of the deaths occurring within the first month of illness. A significant proportion of patients having severe AP (74/248, 29.8%) succumbed to illness, while only 6.4% (7/110) patients with mild or moderately severe AP had mortality within 120 days. On multivariate (Cox regression) analysis, the independent factors predicting 120-day mortality were: CT severity index >5 (OR 4.4), presence of respiratory failure (OR 14.9), presence of circulatory failure (OR 4.4), and severe pancreatitis on admission according to revised Atlanta classification (OR 56.4). Conclusions: Biliary and alcohol are the most common aetiologies of acute pancreatitis in north India. Acute pancreatitis still carries a poor outcome with a 23% mortality rate. Patients having severe pancreatitis at admission, according to revised Atlanta classification, are at the highest risk for mortality and should receive intensive care..