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

Vikesh Singh, Timothy B. Gardner, Georgios I. Papachristou, Mónica Rey-Riveiro, Mahya Faghih, Efstratios Koutroumpakis, Elham Afghani, Nelly G. Acevedo-Piedra, Nikhil Seth, Amitasha Sinha, Noé Quesada-Vázquez, Neftalí Moya-Hoyo, Claudia Sánchez-Marin, Juan Martínez, Félix Lluís, David C. Whitcomb, Pedro Zapater, Enrique de-Madaria

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)491-498
Number of pages8
JournalUnited European Gastroenterology Journal
Volume5
Issue number4
DOIs
StatePublished - Jun 1 2017

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Pancreatitis
Intravenous Administration
Multicenter Studies
Hospital Emergency Service
Resuscitation
Odds Ratio
Length of Stay
Cohort Studies
Retrospective Studies
Confidence Intervals

Keywords

  • acute pancreatitis
  • outcome
  • prognosis
  • Resuscitation
  • treatment

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Singh, V., Gardner, T. B., Papachristou, G. I., Rey-Riveiro, M., Faghih, M., Koutroumpakis, E., ... de-Madaria, E. (2017). An international multicenter study of early intravenous fluid administration and outcome in acute pancreatitis. United European Gastroenterology Journal, 5(4), 491-498. https://doi.org/10.1177/2050640616671077

An international multicenter study of early intravenous fluid administration and outcome in acute pancreatitis. / Singh, Vikesh; Gardner, Timothy B.; Papachristou, Georgios I.; Rey-Riveiro, Mónica; Faghih, Mahya; Koutroumpakis, Efstratios; Afghani, Elham; Acevedo-Piedra, Nelly G.; Seth, Nikhil; Sinha, Amitasha; Quesada-Vázquez, Noé; Moya-Hoyo, Neftalí; Sánchez-Marin, Claudia; Martínez, Juan; Lluís, Félix; Whitcomb, David C.; Zapater, Pedro; de-Madaria, Enrique.

In: United European Gastroenterology Journal, Vol. 5, No. 4, 01.06.2017, p. 491-498.

Research output: Contribution to journalArticle

Singh, V, Gardner, TB, Papachristou, GI, Rey-Riveiro, M, Faghih, M, Koutroumpakis, E, Afghani, E, Acevedo-Piedra, NG, Seth, N, Sinha, A, Quesada-Vázquez, N, Moya-Hoyo, N, Sánchez-Marin, C, Martínez, J, Lluís, F, Whitcomb, DC, Zapater, P & de-Madaria, E 2017, 'An international multicenter study of early intravenous fluid administration and outcome in acute pancreatitis', United European Gastroenterology Journal, vol. 5, no. 4, pp. 491-498. https://doi.org/10.1177/2050640616671077
Singh, Vikesh ; Gardner, Timothy B. ; Papachristou, Georgios I. ; Rey-Riveiro, Mónica ; Faghih, Mahya ; Koutroumpakis, Efstratios ; Afghani, Elham ; Acevedo-Piedra, Nelly G. ; Seth, Nikhil ; Sinha, Amitasha ; Quesada-Vázquez, Noé ; Moya-Hoyo, Neftalí ; Sánchez-Marin, Claudia ; Martínez, Juan ; Lluís, Félix ; Whitcomb, David C. ; Zapater, Pedro ; de-Madaria, Enrique. / An international multicenter study of early intravenous fluid administration and outcome in acute pancreatitis. In: United European Gastroenterology Journal. 2017 ; Vol. 5, No. 4. pp. 491-498.
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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

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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.

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KW - prognosis

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