Site and size of extrapancreatic necrosis are associated with clinical outcomes in patients with acute necrotizing pancreatitis.
Acute pancreatitis
Computed tomography
Extrapancreatic necrosis
Pancreatic collection
Journal
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
06
10
2019
revised:
17
11
2019
accepted:
19
11
2019
pubmed:
30
11
2019
medline:
26
11
2020
entrez:
30
11
2019
Statut:
ppublish
Résumé
The site and size of extrapancreatic necrosis (EPN) as assessed on computed tomography may influence the severity of acute necrotizing pancreatitis (ANP). The objective of the study was to evaluate the impact of site and size of EPN on the clinical outcomes in patients with acute necrotizing pancreatitis (ANP). This retrospective study comprised of consecutive patients with ANP who were admitted between January 2017 and March 2019. Patients in whom the initial contrast enhanced CT showed EPN were eligible for inclusion. The site, volume and maximum dimension of EPN were recorded. The severity of AP and modified CT severity index (MCTSI) was calculated. Clinical outcomes were recorded. A total of 119 patients (mean age, 37.56 years, 91 males) were included. There was a significant association between the location of EPN and the outcome parameters. The left posterior pararenal collections were significantly associated with mortality (P = 0.041), left paracolic gutter collections with the length of hospitalisation (LOH) (P = 0.014), and right paracolic gutter and mesenteric collections with the intensive care unit (ICU) stay (P = 0.024, and P = 0.021, respectively). There was a significant correlation between the volume and the maximum dimension of collection with LOH and ICU stay. The area under the receiver operating characteristic curve for volume, maximum dimension and MCTSI for predicting death was 0.724 (95% CI, 0.612-0.837), 0.644 (95% CI, 0.516-0.772) and 0.574 (95% CI, 0.452-0.696), respectively. The site and size of EPN provide reliable and objective information for assessing clinical outcomes in patients with ANP.
Sections du résumé
BACKGROUND
BACKGROUND
The site and size of extrapancreatic necrosis (EPN) as assessed on computed tomography may influence the severity of acute necrotizing pancreatitis (ANP). The objective of the study was to evaluate the impact of site and size of EPN on the clinical outcomes in patients with acute necrotizing pancreatitis (ANP).
METHOD AND MATERIALS
METHODS
This retrospective study comprised of consecutive patients with ANP who were admitted between January 2017 and March 2019. Patients in whom the initial contrast enhanced CT showed EPN were eligible for inclusion. The site, volume and maximum dimension of EPN were recorded. The severity of AP and modified CT severity index (MCTSI) was calculated. Clinical outcomes were recorded.
RESULTS
RESULTS
A total of 119 patients (mean age, 37.56 years, 91 males) were included. There was a significant association between the location of EPN and the outcome parameters. The left posterior pararenal collections were significantly associated with mortality (P = 0.041), left paracolic gutter collections with the length of hospitalisation (LOH) (P = 0.014), and right paracolic gutter and mesenteric collections with the intensive care unit (ICU) stay (P = 0.024, and P = 0.021, respectively). There was a significant correlation between the volume and the maximum dimension of collection with LOH and ICU stay. The area under the receiver operating characteristic curve for volume, maximum dimension and MCTSI for predicting death was 0.724 (95% CI, 0.612-0.837), 0.644 (95% CI, 0.516-0.772) and 0.574 (95% CI, 0.452-0.696), respectively.
CONCLUSION
CONCLUSIONS
The site and size of EPN provide reliable and objective information for assessing clinical outcomes in patients with ANP.
Identifiants
pubmed: 31780286
pii: S1424-3903(19)30791-4
doi: 10.1016/j.pan.2019.11.010
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
9-15Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 IAP and EPC. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest None.