Prediction of Mortality in Acute Pancreatitis: A Systematic Review of the Published Evidence

Gravante, Gianpiero; Garcea, Giuseppe; Ong, Seok Ling; Metcalfe, Matthew S.; Berry, David P.; Lloyd, David M.; Dennison, Ashley R.

doi:10.1159/000212097

Cited by 111 publications

(78 citation statements)

References 69 publications

(79 reference statements)

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“…Despite advancements in many scoring systems, no single system is a reliable method for predicting mortality. For this evaluation, a scoring system such as APACHE II can be used at regular intervals for AP patients, but imaging assessments may be required as well (28). Ranson et al (29) reported an increased risk of mortality with an increased number of prognostic signs: 25% mortality was reported with >4 prognostic signs.…”

Section: Discussionmentioning

confidence: 99%

Can C-reactive protein levels increase the accuracy of the Ranson score in predicting the severity and prognosis of acute pancreatitis? A prospective cohort study

Başak

Hasbahçeci²,

Şişik³

et al. 2017

Turk J Gastroenterol

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Section: Discussionmentioning

confidence: 99%

Can C-reactive protein levels increase the accuracy of the Ranson score in predicting the severity and prognosis of acute pancreatitis? A prospective cohort study

Başak

Hasbahçeci²,

Şişik³

et al. 2017

Turk J Gastroenterol

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“…However, 15-20% of patients develop a severe form of AP, which is characterised by presence of organ failure and/or local pancreatic complications such as the development of a pseudocyst, abscess or parenchymal necrosis [1]. Most clinical centres report mortality rates for severe AP of 5-15% and some reports even present mortality rates of up to 25% [1,2].…”

Section: Introductionmentioning

confidence: 99%

Diabetes aggravates acute pancreatitis and inhibits pancreas regeneration in mice

et al. 2012

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Aims/hypothesis It is well established that acute pancreatitis often causes diabetes and that a high blood glucose level associated with pancreatitis is a marker of poor prognosis. The aim of this study was to evaluate if diabetes merely reflects the severity of pancreatitis or whether it can also aggravate the progression of this disease in a vicious circle. Methods Reversible acute oedematous pancreatitis was induced in untreated and streptozotocin-treated diabetic mice by injection of cerulein. Progression of pancreatitis was studied by immunohistochemistry, ELISA and various other enzyme assays. The production of regenerating isletderived 3β (REG3β) was determined by western blot and immunohistochemistry. Results While cerulein treatment in non-diabetic mice resulted in acute pancreatitis followed by regeneration of the pancreas within 7 days, diabetes aggravated pancreatitis, inhibited the regeneration of the exocrine tissue and led to strong atrophy of the pancreas. The aggravation of pancreatitis by diabetes was characterised by decreased production of the anti-inflammatory protein REG3β, increased inflammation, augmented oedema formation and increased cell death during the acute phase of pancreatitis (p < 0.05). During the regenerative phase, diabetes augmented inflammation, increased cell death, reduced acinar cell expansion and increased the expansion of duct as well as interstitial cells, resulting in the formation of tubular complexes (p<0.05). Administration of insulin reversed the observed phenotype in diabetic mice. Conclusions/interpretation Diabetes aggravates acute pancreatitis and suppresses regeneration of the exocrine tissue. Thus, diabetes is not just a concomitant phenomenon of pancreatitis, but can have a fundamental influence on the progression of acute pancreatitis.

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“…Between 10 and 20% of patients are qualified as severe AP (SAP) [2][3][4][5]. They have suffered an intense inflammatory response, a variety of local and systemic complications, prolonged hospital stay and significant morbidity and mortality [2].…”

Section: Introductionmentioning

confidence: 99%

“…They have suffered an intense inflammatory response, a variety of local and systemic complications, prolonged hospital stay and significant morbidity and mortality [2]. Mortality in SAP may reach as high as 20-30% [3,4], while the mild form has a mortality of less than 5% [4].…”

Section: Introductionmentioning

confidence: 99%

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Biological markers of severity in acute pancreatitis

et al. 2014

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Prediction of Mortality in Acute Pancreatitis: A Systematic Review of the Published Evidence

Cited by 111 publications

References 69 publications

Can C-reactive protein levels increase the accuracy of the Ranson score in predicting the severity and prognosis of acute pancreatitis? A prospective cohort study

Can C-reactive protein levels increase the accuracy of the Ranson score in predicting the severity and prognosis of acute pancreatitis? A prospective cohort study

Diabetes aggravates acute pancreatitis and inhibits pancreas regeneration in mice

Biological markers of severity in acute pancreatitis

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