TY - JOUR
T1 - Influence of age, body mass index and comorbidity on major outcomes in acute pancreatitis, a prospective nation-wide multicentre study
AU - Moran, Robert A.
AU - García-Rayado, Guillermo
AU - de la Iglesia-García, Daniel
AU - Martínez-Moneo, Emma
AU - Fort-Martorell, Esther
AU - Lauret-Braña, Eugenia
AU - Concepción-Martín, Mar
AU - Ausania, Fabio
AU - Prieto-Martínez, Carlos
AU - González-de-Cabo, Miguel
AU - Quesada-Vázquez, Noé
AU - Marcaide-Ruiz-de-Apodaca, M. Asunción
AU - Pajares-Díaz, José A.
AU - Díaz, Francia C.
AU - de-Benito, José L.
AU - Hinojosa-Guadix, Jennifer
AU - Marqués-García, Pilar
AU - Boadas, Jaume
AU - Bajador-Andreu, Eduardo
AU - Moreno, Oswaldo
AU - Argüelles-Arias, Federico
AU - Martín-Benítez, Gregorio
AU - Tafur-Sánchez, Carla
AU - Leal-Téllez, Jesús
AU - Romero-Mosquera, Beatriz
AU - Hernaez, Ruben
AU - Papachristou, Georgios I.
AU - Singh, Vikesh K.
AU - de-Madaria, Enrique
N1 - Publisher Copyright:
© Author(s) 2018.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Background: There are few large prospective cohort studies evaluating predictors of outcomes in acute pancreatitis. Objectives: The purpose of this study was to determine the role of age and co-morbid disease in predicting major outcomes in acute pancreatitis. Methods: Data points were collected according to a predefined electronic data collection form. Acute pancreatitis and its complications were defined according to the revised Atlanta classification. Univariable and multivariable analyses were conducted using Cox proportional hazard regression and multiple logistic regression. Results: From June 2013–February 2015, 1655 adult patients were recruited from 23 centres across Spain. Co-morbid disease, obesity, open surgical necrosectomy within 30 days, and pancreatic necrosis were independently associated with both 30-day mortality and persistent organ failure (p < 0.05 for all). Age was not associated with persistent organ failure, however the extreme of age (>85 years) was associated with mortality (p < 0.05). Co-morbid disease and obesity were not independently associated with a prolonged length of stay or other markers of morbidity on adjusted analysis (p > 0.05). Conclusion: Comorbidity and obesity are important determinates of mortality and persistent organ failure in acute pancreatitis, but in the absence of organ failure they do not appear to independently contribute to morbidity. This has important implications for severity classification and predictive models of severity in acute pancreatitis.
AB - Background: There are few large prospective cohort studies evaluating predictors of outcomes in acute pancreatitis. Objectives: The purpose of this study was to determine the role of age and co-morbid disease in predicting major outcomes in acute pancreatitis. Methods: Data points were collected according to a predefined electronic data collection form. Acute pancreatitis and its complications were defined according to the revised Atlanta classification. Univariable and multivariable analyses were conducted using Cox proportional hazard regression and multiple logistic regression. Results: From June 2013–February 2015, 1655 adult patients were recruited from 23 centres across Spain. Co-morbid disease, obesity, open surgical necrosectomy within 30 days, and pancreatic necrosis were independently associated with both 30-day mortality and persistent organ failure (p < 0.05 for all). Age was not associated with persistent organ failure, however the extreme of age (>85 years) was associated with mortality (p < 0.05). Co-morbid disease and obesity were not independently associated with a prolonged length of stay or other markers of morbidity on adjusted analysis (p > 0.05). Conclusion: Comorbidity and obesity are important determinates of mortality and persistent organ failure in acute pancreatitis, but in the absence of organ failure they do not appear to independently contribute to morbidity. This has important implications for severity classification and predictive models of severity in acute pancreatitis.
KW - Acute pancreatitis
KW - comorbidities
KW - comorbidity
KW - morbidity
KW - mortality
KW - organ failure
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U2 - 10.1177/2050640618798155
DO - 10.1177/2050640618798155
M3 - Article
C2 - 30574321
AN - SCOPUS:85058112108
VL - 6
SP - 1508
EP - 1518
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
SN - 2050-6406
IS - 10
ER -