Pleuropulmonary pathologies in the early phase of acute pancreatitis correlate with disease severity.
Adult
Aged
Cohort Studies
Comorbidity
Disease Progression
Europe
/ epidemiology
Female
Humans
Lung Diseases
/ epidemiology
Male
Middle Aged
Mortality
Pancreatitis
/ complications
Patient Acuity
Pleural Diseases
/ diagnosis
Prevalence
Prognosis
Respiratory Insufficiency
/ diagnosis
Retrospective Studies
Survival Analysis
Tomography, X-Ray Computed
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2022
2022
Historique:
received:
22
06
2021
accepted:
25
01
2022
entrez:
7
2
2022
pubmed:
8
2
2022
medline:
4
3
2022
Statut:
epublish
Résumé
Respiratory failure worsens the outcome of acute pancreatitis (AP) and underlying factors might be early detectable. To evaluate the prevalence and prognostic relevance of early pleuropulmonary pathologies and pre-existing chronic lung diseases (CLD) in AP patients. Multicentre retrospective cohort study. Caudal sections of the thorax derived from abdominal contrast enhanced computed tomography (CECT) performed in the early phase of AP were assessed. Independent predictors of severe AP were identified by binary logistic regression analysis. A one-year survival analysis using Kaplan-Meier curves and log rank test was performed. 358 patients were analysed, finding pleuropulmonary pathologies in 81%. CECTs were performed with a median of 2 days (IQR 1-3) after admission. Multivariable analysis identified moderate to severe or bilateral pleural effusions (PEs) (OR = 4.16, 95%CI 2.05-8.45, p<0.001) and pre-existing CLD (OR = 2.93, 95%CI 1.17-7.32, p = 0.022) as independent predictors of severe AP. Log rank test showed a significantly worse one-year survival in patients with bilateral compared to unilateral PEs in a subgroup. Increasing awareness of the prognostic impact of large and bilateral PEs and pre-existing CLD could facilitate the identification of patients at high risk for severe AP in the early phase and thus improve their prognosis.
Sections du résumé
BACKGROUND
Respiratory failure worsens the outcome of acute pancreatitis (AP) and underlying factors might be early detectable.
AIMS
To evaluate the prevalence and prognostic relevance of early pleuropulmonary pathologies and pre-existing chronic lung diseases (CLD) in AP patients.
METHODS
Multicentre retrospective cohort study. Caudal sections of the thorax derived from abdominal contrast enhanced computed tomography (CECT) performed in the early phase of AP were assessed. Independent predictors of severe AP were identified by binary logistic regression analysis. A one-year survival analysis using Kaplan-Meier curves and log rank test was performed.
RESULTS
358 patients were analysed, finding pleuropulmonary pathologies in 81%. CECTs were performed with a median of 2 days (IQR 1-3) after admission. Multivariable analysis identified moderate to severe or bilateral pleural effusions (PEs) (OR = 4.16, 95%CI 2.05-8.45, p<0.001) and pre-existing CLD (OR = 2.93, 95%CI 1.17-7.32, p = 0.022) as independent predictors of severe AP. Log rank test showed a significantly worse one-year survival in patients with bilateral compared to unilateral PEs in a subgroup.
CONCLUSIONS
Increasing awareness of the prognostic impact of large and bilateral PEs and pre-existing CLD could facilitate the identification of patients at high risk for severe AP in the early phase and thus improve their prognosis.
Identifiants
pubmed: 35130290
doi: 10.1371/journal.pone.0263739
pii: PONE-D-21-20484
pmc: PMC8820650
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0263739Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Pancreas. 1997 Oct;15(3):222-5
pubmed: 9336784
Gut. 2013 Jan;62(1):102-11
pubmed: 23100216
J Clin Gastroenterol. 2007 Oct;41(9):855-8
pubmed: 17881932
Pancreatology. 2017 Mar - Apr;17(2):155-165
pubmed: 28159463
Forensic Sci Med Pathol. 2015 Dec;11(4):488-96
pubmed: 26541472
Expert Rev Respir Med. 2020 Feb;14(2):209-217
pubmed: 31779502
Am J Surg. 1999 Jan;177(1):7-14
pubmed: 10037300
World J Gastroenterol. 2006 Nov 28;12(44):7087-96
pubmed: 17131469
Am J Gastroenterol. 2010 Feb;105(2):435-41; quiz 442
pubmed: 19861954
Exp Ther Med. 2019 Aug;18(2):1029-1038
pubmed: 31363364
Am J Gastroenterol. 1994 Oct;89(10):1849-51
pubmed: 7942681
United European Gastroenterol J. 2019 Dec;7(10):1312-1320
pubmed: 31839956
Clin Gastroenterol Hepatol. 2005 Feb;3(2):159-66
pubmed: 15704050
Gut. 2008 Dec;57(12):1698-703
pubmed: 18519429
Gastroenterology. 2012 Jun;142(7):1476-82; quiz e15-6
pubmed: 22425589
Quant Imaging Med Surg. 2020 Feb;10(2):451-463
pubmed: 32190570
Int J Pancreatol. 1996 Apr;19(2):113-5
pubmed: 8723553
Aging Clin Exp Res. 2021 Jan;33(1):183-192
pubmed: 32185694
Pancreatology. 2016 Sep-Oct;16(5):756-60
pubmed: 27424478
JOP. 2009 May 18;10(3):271-5
pubmed: 19454818
Br J Anaesth. 2013 Aug;111(2):152-60
pubmed: 23585400
Pancreas. 2015 Nov;44(8):1195-210
pubmed: 26465949
J Clin Diagn Res. 2017 Feb;11(2):PC10-PC13
pubmed: 28384928
N Engl J Med. 2016 Nov 17;375(20):1972-1981
pubmed: 27959604
Br J Surg. 2006 Jun;93(6):738-44
pubmed: 16671062
Pancreatology. 2019 Jun;19(4):519-523
pubmed: 31036490
Pancreatology. 2013 Jul-Aug;13(4 Suppl 2):e1-15
pubmed: 24054878
Pancreatology. 2016 Sep-Oct;16(5):791-7
pubmed: 27592205