TY - JOUR
T1 - An international multicenter study of early intravenous fluid administration and outcome in acute pancreatitis
AU - Singh, Vikesh K.
AU - Gardner, Timothy B.
AU - Papachristou, Georgios I.
AU - Rey-Riveiro, Mónica
AU - Faghih, Mahya
AU - Koutroumpakis, Efstratios
AU - Afghani, Elham
AU - Acevedo-Piedra, Nelly G.
AU - Seth, Nikhil
AU - Sinha, Amitasha
AU - Quesada-Vázquez, Noé
AU - Moya-Hoyo, Neftalí
AU - Sánchez-Marin, Claudia
AU - Martínez, Juan
AU - Lluís, Félix
AU - Whitcomb, David C.
AU - Zapater, Pedro
AU - de-Madaria, Enrique
N1 - Publisher Copyright:
© 2016, © Author(s) 2016.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - 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.
AB - 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.
KW - Resuscitation
KW - acute pancreatitis
KW - outcome
KW - prognosis
KW - treatment
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U2 - 10.1177/2050640616671077
DO - 10.1177/2050640616671077
M3 - Article
C2 - 28588879
AN - SCOPUS:85019651785
SN - 2050-6406
VL - 5
SP - 491
EP - 498
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 4
ER -