Risk Stratification in Post-ERCP Pancreatitis: How Do Procedures, Patient Characteristics and Clinical Indicators Influence Outcomes?

ALT AST ERCP bilirubin lipase pancreatitis

Journal

Pathophysiology : the official journal of the International Society for Pathophysiology
ISSN: 1873-149X
Titre abrégé: Pathophysiology
Pays: Switzerland
ID NLM: 9433813

Informations de publication

Date de publication:
20 Feb 2021
Historique:
received: 12 12 2020
revised: 24 01 2021
accepted: 31 01 2021
entrez: 2 4 2022
pubmed: 20 2 2021
medline: 20 2 2021
Statut: epublish

Résumé

Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains common, and severe complications are associated with ERCP. There is no previous study detailing the effect of race and gender in a US-based population on risk of PEP. Data were collected on 269 "first-performed" consecutive ERCPs followed by division by race (White vs. African-American) and sex (Female vs. Male). A total of 53 probable risk factors were evaluated by uni- and multivariate analysis followed by outcomes expressed as an odds ratio (OR) (with a 95% confidence interval, 95% CI). Finally, a principal component analysis was performed to construct a risk prediction model for PEP, which can be used by clinicians at bedside. After analyzing the risk factors based on race and gender-based groups, Caucasian males with PEP are more likely to have prior history of pancreatitis ( It is very evident that both patient and procedure-related risk factors vary by race and gender in the US population, leading to the development of a new risk assessment tool for PEP that can be used in clinical practice. We need to follow up with a larger prospective study to validate this novel race and gender-based risk scoring system for PEP.

Sections du résumé

BACKGROUND BACKGROUND
Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains common, and severe complications are associated with ERCP. There is no previous study detailing the effect of race and gender in a US-based population on risk of PEP.
METHODS METHODS
Data were collected on 269 "first-performed" consecutive ERCPs followed by division by race (White vs. African-American) and sex (Female vs. Male). A total of 53 probable risk factors were evaluated by uni- and multivariate analysis followed by outcomes expressed as an odds ratio (OR) (with a 95% confidence interval, 95% CI). Finally, a principal component analysis was performed to construct a risk prediction model for PEP, which can be used by clinicians at bedside.
RESULTS RESULTS
After analyzing the risk factors based on race and gender-based groups, Caucasian males with PEP are more likely to have prior history of pancreatitis (
CONCLUSIONS CONCLUSIONS
It is very evident that both patient and procedure-related risk factors vary by race and gender in the US population, leading to the development of a new risk assessment tool for PEP that can be used in clinical practice. We need to follow up with a larger prospective study to validate this novel race and gender-based risk scoring system for PEP.

Identifiants

pubmed: 35366271
pii: pathophysiology28010007
doi: 10.3390/pathophysiology28010007
pmc: PMC8830468
doi:

Types de publication

Journal Article

Langues

eng

Pagination

76-85

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Auteurs

Kapil Kohli (K)

Departments of Medicine/Section of Gastroenterology and Hepatology, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103-3932, USA.

Hrishikesh Samant (H)

Departments of Medicine/Section of Gastroenterology and Hepatology, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103-3932, USA.

Kashif Khan (K)

Departments of Medicine/Section of Gastroenterology and Hepatology, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103-3932, USA.

Sudha Pandit (S)

Departments of Medicine/Section of Gastroenterology and Hepatology, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103-3932, USA.

Kelli Morgan (K)

Departments of Medicine/Section of Gastroenterology and Hepatology, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103-3932, USA.

Urska Cvek (U)

Department of Computer Sciences, Louisiana State University-Shreveport, Shreveport, LA 71115, USA.

Phillip Kilgore (P)

Department of Computer Sciences, Louisiana State University-Shreveport, Shreveport, LA 71115, USA.

Marjan Trutschl (M)

Department of Computer Sciences, Louisiana State University-Shreveport, Shreveport, LA 71115, USA.

Eleni Mijalis (E)

Departments of Medicine/Section of Gastroenterology and Hepatology, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103-3932, USA.

Paul Jordan (P)

Departments of Medicine/Section of Gastroenterology and Hepatology, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103-3932, USA.

James Morris (J)

Departments of Medicine/Section of Gastroenterology and Hepatology, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103-3932, USA.

Moheb Boktor (M)

Department of Internal Medicine, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.

Jonathan Steven Alexander (JS)

Departments of Medicine/Section of Gastroenterology and Hepatology, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103-3932, USA.
Department of Molecular and Cellular Physiology, Louisiana State University, 1501 Kings Highway, Shreveport, LA 71103-3932, USA.

Classifications MeSH