Does the duration of abdominal pain prior to admission influence the severity of acute pancreatitis?

Karan Kapoor, Kathryn Repas, Vikesh Singh, Darwin L. Conwell, Koenraad J. Mortele, Bechien U. Wu, Peter A. Banks

Research output: Contribution to journalArticle

Abstract

Context In a prior report involving patients with hemoconcentration at admission, those with necrotizing pancreatitis presented significantly earlier than those with interstitial disease suggesting that duration of abdominal pain prior to presentation may have prognostic significance in acute pancreatitis. Objectives The aim of the present study was to determine whether the duration of abdominal pain prior to admission influences the severity of acute pancreatitis. Methods During a five-year period, all patients presenting directly to our hospital with their first episode of acute pancreatitis were enrolled in a cohort study. We analyzed data obtained from records of all such patients and performed a separate analysis on those with hemoconcentration (hematocrit equal to, or greater than, 44%) at presentation to determine whether duration of abdominal pain prior to presentation was associated with severity of acute pancreatitis. Duration of abdominal pain was categorized as persisting for either less than 12 h or 12 h or more prior to arrival. Prognostic markers of severity included admission hematocrit and blood urea nitrogen (BUN), as well as the development of systemic inflammatory response syndrome (SIRS) during the initial 24 h of hospitalization. Outcome measures included pancreatic necrosis based on contrast-enhanced CT scanning, need for intensive care, length of hospitalization, and death. Radiologic severity of peripancreatic inflammatory changes was assessed within 48 h of admission in accordance with the Balthazar-Ranson scoring system (A-E). Results Among a total of 318 patients, there were 62 (19.5%) with hemoconcentration at admission. Among the 318 patients, there was no significant difference in the prevalence of pancreatic necrosis when comparing the less than 12 h group to the 12 h or more group. Among the 62 patients with hemoconcentration, those admitted within 12 h compared to those admitted 12 h or more following the onset of abdominal pain had an increased radiologic severity of acute pancreatitis (Balthazar-Ranson grade D or E: 83.3% vs. 40.0%; P=0.006) and an increased prevalence of pancreatic necrosis (21.1% vs. 2.3%; P=0.028). Conclusion Duration of abdominal pain prior to admission impacts the severity of acute pancreatitis only among patients with hemoconcentration at presentation.

Original languageEnglish (US)
Pages (from-to)171-175
Number of pages5
JournalJournal of the Pancreas
Volume14
Issue number2
StatePublished - Mar 2013

Fingerprint

Pancreatitis
Abdominal Pain
Necrosis
Hematocrit
Hospitalization
Systemic Inflammatory Response Syndrome
Blood Urea Nitrogen
Critical Care
Cohort Studies
Outcome Assessment (Health Care)

Keywords

  • Acute disease
  • Early diagnosis
  • Pancreatitis /radiography
  • Severity of illness index
  • Tomography
  • X-ray computed

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Hepatology

Cite this

Kapoor, K., Repas, K., Singh, V., Conwell, D. L., Mortele, K. J., Wu, B. U., & Banks, P. A. (2013). Does the duration of abdominal pain prior to admission influence the severity of acute pancreatitis? Journal of the Pancreas, 14(2), 171-175.

Does the duration of abdominal pain prior to admission influence the severity of acute pancreatitis? / Kapoor, Karan; Repas, Kathryn; Singh, Vikesh; Conwell, Darwin L.; Mortele, Koenraad J.; Wu, Bechien U.; Banks, Peter A.

In: Journal of the Pancreas, Vol. 14, No. 2, 03.2013, p. 171-175.

Research output: Contribution to journalArticle

Kapoor, K, Repas, K, Singh, V, Conwell, DL, Mortele, KJ, Wu, BU & Banks, PA 2013, 'Does the duration of abdominal pain prior to admission influence the severity of acute pancreatitis?', Journal of the Pancreas, vol. 14, no. 2, pp. 171-175.
Kapoor, Karan ; Repas, Kathryn ; Singh, Vikesh ; Conwell, Darwin L. ; Mortele, Koenraad J. ; Wu, Bechien U. ; Banks, Peter A. / Does the duration of abdominal pain prior to admission influence the severity of acute pancreatitis?. In: Journal of the Pancreas. 2013 ; Vol. 14, No. 2. pp. 171-175.
@article{9e3188706eb34903a2920c66f64cd639,
title = "Does the duration of abdominal pain prior to admission influence the severity of acute pancreatitis?",
abstract = "Context In a prior report involving patients with hemoconcentration at admission, those with necrotizing pancreatitis presented significantly earlier than those with interstitial disease suggesting that duration of abdominal pain prior to presentation may have prognostic significance in acute pancreatitis. Objectives The aim of the present study was to determine whether the duration of abdominal pain prior to admission influences the severity of acute pancreatitis. Methods During a five-year period, all patients presenting directly to our hospital with their first episode of acute pancreatitis were enrolled in a cohort study. We analyzed data obtained from records of all such patients and performed a separate analysis on those with hemoconcentration (hematocrit equal to, or greater than, 44{\%}) at presentation to determine whether duration of abdominal pain prior to presentation was associated with severity of acute pancreatitis. Duration of abdominal pain was categorized as persisting for either less than 12 h or 12 h or more prior to arrival. Prognostic markers of severity included admission hematocrit and blood urea nitrogen (BUN), as well as the development of systemic inflammatory response syndrome (SIRS) during the initial 24 h of hospitalization. Outcome measures included pancreatic necrosis based on contrast-enhanced CT scanning, need for intensive care, length of hospitalization, and death. Radiologic severity of peripancreatic inflammatory changes was assessed within 48 h of admission in accordance with the Balthazar-Ranson scoring system (A-E). Results Among a total of 318 patients, there were 62 (19.5{\%}) with hemoconcentration at admission. Among the 318 patients, there was no significant difference in the prevalence of pancreatic necrosis when comparing the less than 12 h group to the 12 h or more group. Among the 62 patients with hemoconcentration, those admitted within 12 h compared to those admitted 12 h or more following the onset of abdominal pain had an increased radiologic severity of acute pancreatitis (Balthazar-Ranson grade D or E: 83.3{\%} vs. 40.0{\%}; P=0.006) and an increased prevalence of pancreatic necrosis (21.1{\%} vs. 2.3{\%}; P=0.028). Conclusion Duration of abdominal pain prior to admission impacts the severity of acute pancreatitis only among patients with hemoconcentration at presentation.",
keywords = "Acute disease, Early diagnosis, Pancreatitis /radiography, Severity of illness index, Tomography, X-ray computed",
author = "Karan Kapoor and Kathryn Repas and Vikesh Singh and Conwell, {Darwin L.} and Mortele, {Koenraad J.} and Wu, {Bechien U.} and Banks, {Peter A.}",
year = "2013",
month = "3",
language = "English (US)",
volume = "14",
pages = "171--175",
journal = "Journal of the Pancreas",
issn = "1590-8577",
publisher = "E.S. Burioni Ricerche Bibliografiche",
number = "2",

}

TY - JOUR

T1 - Does the duration of abdominal pain prior to admission influence the severity of acute pancreatitis?

AU - Kapoor, Karan

AU - Repas, Kathryn

AU - Singh, Vikesh

AU - Conwell, Darwin L.

AU - Mortele, Koenraad J.

AU - Wu, Bechien U.

AU - Banks, Peter A.

PY - 2013/3

Y1 - 2013/3

N2 - Context In a prior report involving patients with hemoconcentration at admission, those with necrotizing pancreatitis presented significantly earlier than those with interstitial disease suggesting that duration of abdominal pain prior to presentation may have prognostic significance in acute pancreatitis. Objectives The aim of the present study was to determine whether the duration of abdominal pain prior to admission influences the severity of acute pancreatitis. Methods During a five-year period, all patients presenting directly to our hospital with their first episode of acute pancreatitis were enrolled in a cohort study. We analyzed data obtained from records of all such patients and performed a separate analysis on those with hemoconcentration (hematocrit equal to, or greater than, 44%) at presentation to determine whether duration of abdominal pain prior to presentation was associated with severity of acute pancreatitis. Duration of abdominal pain was categorized as persisting for either less than 12 h or 12 h or more prior to arrival. Prognostic markers of severity included admission hematocrit and blood urea nitrogen (BUN), as well as the development of systemic inflammatory response syndrome (SIRS) during the initial 24 h of hospitalization. Outcome measures included pancreatic necrosis based on contrast-enhanced CT scanning, need for intensive care, length of hospitalization, and death. Radiologic severity of peripancreatic inflammatory changes was assessed within 48 h of admission in accordance with the Balthazar-Ranson scoring system (A-E). Results Among a total of 318 patients, there were 62 (19.5%) with hemoconcentration at admission. Among the 318 patients, there was no significant difference in the prevalence of pancreatic necrosis when comparing the less than 12 h group to the 12 h or more group. Among the 62 patients with hemoconcentration, those admitted within 12 h compared to those admitted 12 h or more following the onset of abdominal pain had an increased radiologic severity of acute pancreatitis (Balthazar-Ranson grade D or E: 83.3% vs. 40.0%; P=0.006) and an increased prevalence of pancreatic necrosis (21.1% vs. 2.3%; P=0.028). Conclusion Duration of abdominal pain prior to admission impacts the severity of acute pancreatitis only among patients with hemoconcentration at presentation.

AB - Context In a prior report involving patients with hemoconcentration at admission, those with necrotizing pancreatitis presented significantly earlier than those with interstitial disease suggesting that duration of abdominal pain prior to presentation may have prognostic significance in acute pancreatitis. Objectives The aim of the present study was to determine whether the duration of abdominal pain prior to admission influences the severity of acute pancreatitis. Methods During a five-year period, all patients presenting directly to our hospital with their first episode of acute pancreatitis were enrolled in a cohort study. We analyzed data obtained from records of all such patients and performed a separate analysis on those with hemoconcentration (hematocrit equal to, or greater than, 44%) at presentation to determine whether duration of abdominal pain prior to presentation was associated with severity of acute pancreatitis. Duration of abdominal pain was categorized as persisting for either less than 12 h or 12 h or more prior to arrival. Prognostic markers of severity included admission hematocrit and blood urea nitrogen (BUN), as well as the development of systemic inflammatory response syndrome (SIRS) during the initial 24 h of hospitalization. Outcome measures included pancreatic necrosis based on contrast-enhanced CT scanning, need for intensive care, length of hospitalization, and death. Radiologic severity of peripancreatic inflammatory changes was assessed within 48 h of admission in accordance with the Balthazar-Ranson scoring system (A-E). Results Among a total of 318 patients, there were 62 (19.5%) with hemoconcentration at admission. Among the 318 patients, there was no significant difference in the prevalence of pancreatic necrosis when comparing the less than 12 h group to the 12 h or more group. Among the 62 patients with hemoconcentration, those admitted within 12 h compared to those admitted 12 h or more following the onset of abdominal pain had an increased radiologic severity of acute pancreatitis (Balthazar-Ranson grade D or E: 83.3% vs. 40.0%; P=0.006) and an increased prevalence of pancreatic necrosis (21.1% vs. 2.3%; P=0.028). Conclusion Duration of abdominal pain prior to admission impacts the severity of acute pancreatitis only among patients with hemoconcentration at presentation.

KW - Acute disease

KW - Early diagnosis

KW - Pancreatitis /radiography

KW - Severity of illness index

KW - Tomography

KW - X-ray computed

UR - http://www.scopus.com/inward/record.url?scp=84875043557&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875043557&partnerID=8YFLogxK

M3 - Article

VL - 14

SP - 171

EP - 175

JO - Journal of the Pancreas

JF - Journal of the Pancreas

SN - 1590-8577

IS - 2

ER -