A systematic review of the extra-pancreatic infectious complications in acute pancreatitis

Brown, Lisa M.; Hore, Todd; Phillips, Anthony G.; Windsor, John A.; Petrov, Maxim S.

doi:10.1016/j.pan.2014.05.430

Cited by 7 publications

(14 citation statements)

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“…Infections, such as bacteraemia, pneumonia, and urinary tract infection, can also occur in extrapancreatic sites [13]. Moreover, the presence of extrapancreatic complications contributes to morbidity and mortality [14].…”

Section: Introductionmentioning

confidence: 99%

The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study

et al. 2020

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Background: The occurrence of infectious complications characterizes the more severe forms of acute pancreatitis (AP) and is associated with high mortality. We investigated the effects of infection at different sites in patients with AP, including those with necrotizing pancreatitis (NP). Methods: We conducted a retrospective analysis of 285 patients who met the inclusion criteria for AP and were admitted to Tianjin Nankai Hospital between January 2016 and September 2019. According to the source of the culture positivity during hospitalization, patients were divided into four groups: sterile group(n = 148), pancreatic infection group(n = 65), extrapancreatic infection group(n = 22) and combined infection group(n = 50). The source of infection, microbiology, biochemical parameters and prognostic indicators were analyzed. Results: In terms of baseline characteristics, the four groups were similar in age, sex, aetiology, previous pancreatitis and diabetes. Compared with the severity of the disease in the other groups, the APACHE II scores(9.91 ± 4.65, 9.46 ± 5.05, respectively) and organ failure rate (40.9 and 50%, respectively)were higher in the extrapancreatic infection group and the combined infection group (P < 0.05). The frequency of surgical intervention and hospitalization time in patients with NP complicated with extrapancreatic infection was greatly increased (P < 0.05). Regarding the primary outcome, patients in the combined infection group had longer hospital stays (68.28 ± 51.80 vs 55.58 ± 36.24, P < 0.05) and higher mortality (24.0% vs 9.2%, P < 0.05) than patients in the pancreatic infection group. In addition, patients in the extrapancreatic infection group also showed high intensive care utilization (59.1%) and mortality rates (18.2%). Among the 137 AP patients with infection complications, 89 patients exhibited multidrug-resistant (MDR) microorganisms, and the mortality rate of patients with MDR bacterial infection was higher than that of patients with non-MDR bacterial infection (24.7% vs 3.6%, P = 0.001). Conclusion: Clinicians should be aware that extrapancreatic infection (EPI) significantly aggravates the main outcome in pancreatic infection patients. Infection with MDR bacteria is also associated with AP mortality.

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Section: Introductionmentioning

confidence: 99%

The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study

et al. 2020

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“…The rates of extra‐abdominal infectious complications were high compared with other studies of ICU patients as well as studies assessing all patients with AP . These have been shown to increase the risk of infected pancreatic necrosis, as well as being a source of sepsis . Prophylactic antibiotics have not been shown to be beneficial and this is reflected in the current guidelines .…”

Section: Discussionmentioning

confidence: 91%

Admission, management and outcomes of acute pancreatitis in intensive care

Russell

Mittal

Brown

et al. 2016

ANZ Journal of Surgery

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“…If necrotic tissue becomes infected, the patient's condition can rapidly deteriorate to a life-threatening status. 5,6 Early assessment of the severity of AP and its prognosis, as well as the indications and timing of surgical treatment for complications, are hot topics in current research. 7 The costimulatory molecule B7-H4 was discovered by Gabriel L in 2004.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of serum soluble B7‐H4 in acute pancreatitis

Cheng

Liu

Yuan

et al. 2020

Eur J Clin Investigation

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Background: Studies reported that soluble B7-H4 (sB7-H4) was significantly related to the progression and prognosis of inflammatory diseases, and whether sB7-H4 is related to the severity and prognosis of acute pancreatitis (AP) timely has not been reported. Materials and methods: Clinical database data of 446 AP patients were retrospectively collected, and the correlation between the expression serum levels of sB7-H4 with inflammatory factors and prognostic scores was analysed in AP patients. Results: Soluble B7-H4 was significantly correlated with IL-6, IL-8, TNF-α, PCT, CRP levels and WBC count (P < .01), with correlation coefficients of R = .61, .53, .46, .60, .57 and .47, respectively, and AUCs were 0.905, 0.837, 0.797, 0.858, 0.890, 0.841 and 0.855, respectively. In addition, sB7-H4 was significantly correlated with the Ranson score, APACHE II score and BISAP score (P < .001), with correlation coefficients of R = .58, .63 and .59, respectively. The AUCs of assessing local complications of AP were 0.908, 0.863, 0.785 and 0.844, respectively; assessing organ failure were 0.872, 0.790, 0.796 and 0.857, respectively; and assessing in-hospital mortality were 0.839, 0.821, 0.796 and 0.823, respectively. Conclusions: Soluble B7-H4 could be used as a marker for the diagnosis, severity assessment and poor prognosis assessment of AP patients, which may have potential clinical applications.

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A systematic review of the extra-pancreatic infectious complications in acute pancreatitis

Cited by 7 publications

References 0 publications

The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study

The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study

Admission, management and outcomes of acute pancreatitis in intensive care

Predictive value of serum soluble B7‐H4 in acute pancreatitis

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