Chaochao Tan1, Li Yang2, Fengxia Shi3, Jiliang Hu4, Xingwen Zhang5, Yupeng Wang1, Zhonghua Deng1, Jiang Li1, Hao Yuan1, Ting Shi1, Cunyan Li1, Yan Xiao6, Ya Peng2, Wen Xu1, Ying Huang7. 1. Department of Clinical Laboratory, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China. 2. Department of Gastroenterology, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China. 3. Radiology Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China. 4. School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Changsha, China. 5. Department of Emergency, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jiefang Road, Changsha, 410005, Hunan, People's Republic of China. 6. Intensive Care Unit, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China. 7. Department of Emergency, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 61 Jiefang Road, Changsha, 410005, Hunan, People's Republic of China. carmen_huang@163.com.
Abstract
BACKGROUND AND PURPOSE: Systemic inflammatory response syndrome (SIRS) was considered to play an important role in the progress of acute pancreatitis, but its specific relation with infected pancreatic necrosis remains largely unclear. We aimed to investigate the correlation between SIRS duration and infected pancreatic necrosis, and its application in prediction of infected pancreatic necrosis. METHODS: A prospective observational cohort study of 2130 patients with acute pancreatitis from 2012 to 2017. The SIRS duration at the first week was registered daily, and demographic, radiology, and all clinical laboratory data were prospectively collected and retrospectively reviewed. RESULTS: A significant upward tendency of infected pancreatic necrosis incidence was observed with increased SIRS duration. In multivariate logistic regression, SIRS duration (odds ratio, 1.305; 95% CI, 1.161-1.468) was independently associated with infected pancreatic necrosis. ROC analysis demonstrated that the areas under curves of SIRS duration for predicting persistent multi-organ failure, pancreatic infection, and mortality were 0.97 (95% CI, 0.96-0.98), 0.92 (95% CI, 0.91-0.94), and 0.86 (95% CI, 0.83-0.90), respectively, which were comparable to, or even greater than, the area under curves of APACHE II and CT severity index scores. CONCLUSIONS: Early SIRS duration was strongly associated with infected pancreatic necrosis and could serve as an easy bedside indicator to predict pancreatic infection.
BACKGROUND AND PURPOSE: Systemic inflammatory response syndrome (SIRS) was considered to play an important role in the progress of acute pancreatitis, but its specific relation with infected pancreatic necrosis remains largely unclear. We aimed to investigate the correlation between SIRS duration and infected pancreatic necrosis, and its application in prediction of infected pancreatic necrosis. METHODS: A prospective observational cohort study of 2130 patients with acute pancreatitis from 2012 to 2017. The SIRS duration at the first week was registered daily, and demographic, radiology, and all clinical laboratory data were prospectively collected and retrospectively reviewed. RESULTS: A significant upward tendency of infected pancreatic necrosis incidence was observed with increased SIRS duration. In multivariate logistic regression, SIRS duration (odds ratio, 1.305; 95% CI, 1.161-1.468) was independently associated with infected pancreatic necrosis. ROC analysis demonstrated that the areas under curves of SIRS duration for predicting persistent multi-organ failure, pancreatic infection, and mortality were 0.97 (95% CI, 0.96-0.98), 0.92 (95% CI, 0.91-0.94), and 0.86 (95% CI, 0.83-0.90), respectively, which were comparable to, or even greater than, the area under curves of APACHE II and CT severity index scores. CONCLUSIONS: Early SIRS duration was strongly associated with infected pancreatic necrosis and could serve as an easy bedside indicator to predict pancreatic infection.
Authors: Bettina M Rau; Esko A Kemppainen; Andrew A Gumbs; Markus W Büchler; Karl Wegscheider; Claudio Bassi; Pauli A Puolakkainen; Hans G Beger Journal: Ann Surg Date: 2007-05 Impact factor: 12.969
Authors: Vikesh K Singh; Bechien U Wu; Thomas L Bollen; Kathryn Repas; Rie Maurer; Koenraad J Mortele; Peter A Banks Journal: Clin Gastroenterol Hepatol Date: 2009-08-15 Impact factor: 11.382
Authors: V Marco Ranieri; Gordon D Rubenfeld; B Taylor Thompson; Niall D Ferguson; Ellen Caldwell; Eddy Fan; Luigi Camporota; Arthur S Slutsky Journal: JAMA Date: 2012-06-20 Impact factor: 56.272
Authors: Anne Nieminen; Mikael Maksimow; Panu Mentula; Lea Kyhälä; Leena Kylänpää; Pauli Puolakkainen; Esko Kemppainen; Heikki Repo; Marko Salmi Journal: Crit Care Date: 2014-05-21 Impact factor: 9.097