Dataset Information

An international multicenter study of early intravenous fluid administration and outcome in acute pancreatitis.

ABSTRACT:

Aims

Early aggressive fluid resuscitation in acute pancreatitis is frequently recommended but its benefits remain unproven. The aim of this study was to determine the outcomes associated with early fluid volume administration in the emergency room (FVER) in patients with acute pancreatitis.

Methods

A four-center retrospective cohort study of 1010 patients with acute pancreatitis was conducted. FVER was defined as any fluid administered from the time of arrival to the emergency room to 4?h after diagnosis of acute pancreatitis, and was divided into tertiles: nonaggressive (<500?ml), moderate (500 to 1000?ml), and aggressive (>1000?ml).

Results

Two hundred sixty-nine (26.6%), 427 (42.3%), and 314 (31.1%) patients received nonaggressive, moderate, and aggressive FVER respectively. Compared with the nonaggressive fluid group, the moderate group was associated with lower rates of local complications in univariable analysis, and interventions, both in univariable and multivariable analysis (adjusted odds ratio (95% confidence interval): 0.37 (0.14-0.98)). The aggressive resuscitation group was associated with a significantly lower need for interventions, both in univariable and multivariable analysis (adjusted odds ratio 0.21 (0.05-0.84)). Increasing fluid administration categories were associated with decreasing hospital stay in univariable analysis.

Conclusions

Early moderate to aggressive FVER was associated with lower need for invasive interventions.

SUBMITTER: Singh VK

PROVIDER: S-EPMC5446144 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

An international multicenter study of early intravenous fluid administration and outcome in acute pancreatitis.

Singh Vikesh K VK Gardner Timothy B TB Papachristou Georgios I GI Rey-Riveiro Mónica M Faghih Mahya M Koutroumpakis Efstratios E Afghani Elham E Acevedo-Piedra Nelly G NG Seth Nikhil N Sinha Amitasha A Quesada-Vázquez Noé N Moya-Hoyo Neftalí N Sánchez-Marin Claudia C Martínez Juan J Lluís Félix F Whitcomb David C DC Zapater Pedro P de-Madaria Enrique E

United European gastroenterology journal 20160920 4

<h4>Aims</h4>Early aggressive fluid resuscitation in acute pancreatitis is frequently recommended but its benefits remain unproven. The aim of this study was to determine the outcomes associated with early fluid volume administration in the emergency room (FVER) in patients with acute pancreatitis.<h4>Methods</h4>A four-center retrospective cohort study of 1010 patients with acute pancreatitis was conducted. FVER was defined as any fluid administered from the time of arrival to the emergency roo ...[more]

PMID: 28588879

Similar Datasets

Project description:BackgroundThe effect of analgesic modalities on short-term outcomes in acute pancreatitis remains unknown. However, preclinical models have raised safety concerns regarding opioid use in patients with acute pancreatitis.ObjectiveThis study aimed to assess the association between analgesics, particularly opioids, and severity and mortality in hospitalised patients with acute pancreatitis.MethodsThis prospective multicentre cohort study recruited consecutive patients admitted with a first episode of acute pancreatitis between April 1 and 30 June 2022, with a 1-month follow-up. Data on aetiology, clinical course, and analgesic treatment were collected. The primary outcome was the association between opioid analgesia and acute pancreatitis severity, which was analysed using univariate and multivariate analyses.ResultsAmong a total of 1768 patients, included from 118 centres across 27 countries, 1036 (59%) had opioids administered on admission day, and 167 (9%) received opioids after admission day. On univariate analysis, moderately severe or severe acute pancreatitis was associated with male sex, Asian ethnicity, alcohol aetiology, comorbidity, predicted severe acute pancreatitis, higher pain scores, longer pain duration and opioid treatment (all p < 0.001). On multivariate analysis, comorbidity, alcohol aetiology, longer pain duration and higher pain scores increased the risk of moderately severe or severe acute pancreatitis (all p < 0.001). Furthermore, opioids administered after admission day (but not on admission day) doubled the risk of moderately severe or severe disease (OR 2.07 (95% CI, 1.29-3.33); p = 0.003). Opioid treatment for 6 days or more was an independent risk factor for moderately severe or severe acute pancreatitis (OR 3.21 (95% CI, 2.16-4.79; p < 0.001). On univariate analysis, longer opioid duration was associated with mortality.ConclusionOpioid treatment increased the risk of more severe acute pancreatitis only when administered after admission day or for 6 days or more. Future randomised studies should re-evaluate whether opioids might be safe in acute pancreatitis.

Dataset Information

An international multicenter study of early intravenous fluid administration and outcome in acute pancreatitis.

Aims

Methods

Results

Conclusions

Publications

An international multicenter study of early intravenous fluid administration and outcome in acute pancreatitis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets