Early Predictors of Fluid Sequestration in Acute Pancreatitis: A Validation Study

Amitasha Sinha, Noé Q. Vázquez, Mahya Faghih, Elham Afghani, Atif Zaheer, Mouen Khashab, Anne Marie O'Broin-Lennon, Enriqué De-Madaria, Vikesh Singh

Research output: Contribution to journalArticle

Abstract

Objectives The primary aim of this retrospective study was to externally validate predictors of increased fluid sequestration at 48 hours (FS48) in acute pancreatitis (AP). Methods Patients admitted between January 10 and February 13 with a diagnosis of AP were evaluated. The FS48 was calculated as difference between total fluid input and output in the first 48 hours. Predictors of FS48, such as young age, alcoholic etiology, hemoconcentration, hyperglycemia, and systemic inflammatory response syndrome (SIRS), and outcomes in AP, such as increased length of stay, acute fluid collection(s), necrosis, and persistent organ failure (POF), were defined in accordance with the previous study. Linear regression analysis was performed to evaluate the association between predictors and outcome. Results Two hundred twenty-seven AP patients (mean age, 48 years; 54% men) with a median FS48 of 4.2 L were evaluated. Age younger than 40 years, alcoholic etiology, hemoconcentration, and SIRS independently predicted increased FS48 (P <0.05). Increased FS48 was associated with persistent SIRS and POF (P <0.01). There was a significant trend between number of predictors and FS48 (P <0.001). The presence of 4 predictors or more was associated with higher rates of persistent SIRS and POF (P <0.01). Conclusions Our study validated 4 of 5 predictors of increased FS48 from the previous study. Presence of 4 predictors or more and increased FS48 are both associated with persistent SIRS and POF.

Original languageEnglish (US)
Pages (from-to)306-310
Number of pages5
JournalPancreas
Volume45
Issue number2
DOIs
StatePublished - Feb 1 2016

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Systemic Inflammatory Response Syndrome
Validation Studies
Pancreatitis
Hyperglycemia
Linear Models
Length of Stay
Necrosis
Retrospective Studies
Regression Analysis

Keywords

  • acute pancreatitis
  • fluid sequestration
  • persistent organ failure
  • systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Hepatology
  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Early Predictors of Fluid Sequestration in Acute Pancreatitis : A Validation Study. / Sinha, Amitasha; Vázquez, Noé Q.; Faghih, Mahya; Afghani, Elham; Zaheer, Atif; Khashab, Mouen; O'Broin-Lennon, Anne Marie; De-Madaria, Enriqué; Singh, Vikesh.

In: Pancreas, Vol. 45, No. 2, 01.02.2016, p. 306-310.

Research output: Contribution to journalArticle

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AU - Vázquez, Noé Q.

AU - Faghih, Mahya

AU - Afghani, Elham

AU - Zaheer, Atif

AU - Khashab, Mouen

AU - O'Broin-Lennon, Anne Marie

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AU - Singh, Vikesh

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N2 - Objectives The primary aim of this retrospective study was to externally validate predictors of increased fluid sequestration at 48 hours (FS48) in acute pancreatitis (AP). Methods Patients admitted between January 10 and February 13 with a diagnosis of AP were evaluated. The FS48 was calculated as difference between total fluid input and output in the first 48 hours. Predictors of FS48, such as young age, alcoholic etiology, hemoconcentration, hyperglycemia, and systemic inflammatory response syndrome (SIRS), and outcomes in AP, such as increased length of stay, acute fluid collection(s), necrosis, and persistent organ failure (POF), were defined in accordance with the previous study. Linear regression analysis was performed to evaluate the association between predictors and outcome. Results Two hundred twenty-seven AP patients (mean age, 48 years; 54% men) with a median FS48 of 4.2 L were evaluated. Age younger than 40 years, alcoholic etiology, hemoconcentration, and SIRS independently predicted increased FS48 (P <0.05). Increased FS48 was associated with persistent SIRS and POF (P <0.01). There was a significant trend between number of predictors and FS48 (P <0.001). The presence of 4 predictors or more was associated with higher rates of persistent SIRS and POF (P <0.01). Conclusions Our study validated 4 of 5 predictors of increased FS48 from the previous study. Presence of 4 predictors or more and increased FS48 are both associated with persistent SIRS and POF.

AB - Objectives The primary aim of this retrospective study was to externally validate predictors of increased fluid sequestration at 48 hours (FS48) in acute pancreatitis (AP). Methods Patients admitted between January 10 and February 13 with a diagnosis of AP were evaluated. The FS48 was calculated as difference between total fluid input and output in the first 48 hours. Predictors of FS48, such as young age, alcoholic etiology, hemoconcentration, hyperglycemia, and systemic inflammatory response syndrome (SIRS), and outcomes in AP, such as increased length of stay, acute fluid collection(s), necrosis, and persistent organ failure (POF), were defined in accordance with the previous study. Linear regression analysis was performed to evaluate the association between predictors and outcome. Results Two hundred twenty-seven AP patients (mean age, 48 years; 54% men) with a median FS48 of 4.2 L were evaluated. Age younger than 40 years, alcoholic etiology, hemoconcentration, and SIRS independently predicted increased FS48 (P <0.05). Increased FS48 was associated with persistent SIRS and POF (P <0.01). There was a significant trend between number of predictors and FS48 (P <0.001). The presence of 4 predictors or more was associated with higher rates of persistent SIRS and POF (P <0.01). Conclusions Our study validated 4 of 5 predictors of increased FS48 from the previous study. Presence of 4 predictors or more and increased FS48 are both associated with persistent SIRS and POF.

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