The Utility of the Systemic Inflammatory Respsonse Syndrome Score on Admission in Children With Acute Pancreatitis

Grover, Amit S.; Kadiyala, Vivek; Banks, Peter A.; Grand, Richard J.; Conwell, Darwin L.; Lightdale, Jenifer R.

doi:10.1097/mpa.0000000000000681

Cited by 16 publications

(8 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, we believe that having SIRS on admission is a tool that can help stratify risk in children with AP. Our results echo a prior study from Boston Children's hospital which indicated that SIRS on admission was an independent predictor for ICU admission, which was one of our criteria for SAP (13). The same report indicated that SIRS was also an independent predictor for LOS, which we confirmed in our univariate analysis.…”

Section: Discussionsupporting

confidence: 89%

“…There have been previous attempts to develop predictive scoring systems derived from pediatric cohorts (11)(12)(13)(14). These studies have, however, not been validated in clinical practice.…”

Section: What Is Newmentioning

confidence: 99%

“…To reflect pediatric physiology, at least one of the criteria must be hyperthermia/hypothermia or leukocytosis/leukopenia. In the pediatric pancreatitis population, SIRS on admission has been demonstrated to be an independent predictor of length of stay (LOS) and pediatric intensive care unit (PICU) admission after controlling for age and the presence of 2 or more comorbid conditions (13).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Validation of Lipase and Systemic Inflammatory Response Syndrome as Prognostic Indicators in Pediatric Acute Pancreatitis

Nauka

Weinstein

Dolinger

et al. 2019

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

Introduction: Acute pancreatitis (AP) is understudied in the pediatric population despite increasing incidence. Although many cases are mild and resolve with supportive care, severe acute pancreatitis (SAP) can be associated with significant morbidity and mortality. There is a lack of pediatric-specific predictive tools to help stratify risk of SAP in children. Methods: A retrospective cohort study of patients with AP or recurrent AP at Cohen Children's Medical Center between 2011 and 2016 was performed. Lipase level and the presence of pediatric systemic inflammatory response syndrome (SIRS) on admission were examined as potential predictors of SAP and length of stay (LOS). A multivariate logistic regression or analysis of covariance was used to conduct the multivariate analysis. Results: Seventy-nine pediatric patients met inclusion criteria. Approximately 37% (29/79) had SIRS on admission, 22% (17/79) developed SAP, and there were no mortalities. In both the univariate and multivariate models, SIRS was a predictor of SAP. Mean (SD) LOS for patients with SIRS compared with without SIRS was 9.6 ± 8.3 compared with 6.3 ± 6.9 days (P < 0.05). The mean LOS of patients with one or more comorbidity (48%, 38/79) was 10.0 ± 9.5 compared with 5.2 ± 4.0 days (P < 0.01) for those patients without any comorbidities. Only the presence of comorbidities predicted length of time spent nil per os (NPO; P = 0.0022). Patients with comorbidities stayed an average of 5.6 ± 7.6 days NPO, whereas those without comorbidities spent 2.8 ± 2.4 days NPO. Lipase was not predictive of SAP, LOS, or length of time spent NPO. Conclusions: These results support the use of SIRS as a simple screening tool on admission to identify children at risk for the development of SAP. The presence of any comorbidity was predictive of LOS and length of NPO in the multivariate model. This may reflect that comorbidities prolong pancreatitis or influence disposition planning.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: What Is Newmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Validation of Lipase and Systemic Inflammatory Response Syndrome as Prognostic Indicators in Pediatric Acute Pancreatitis

Nauka

Weinstein

Dolinger

et al. 2019

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

show abstract

“…Grover et al conducted similar study in 50 pediatric patients where they found two or more SIRS criteria at admission had longer hospital stay (median 8 days, 4-13 days) as compared to patients without SIRS (median 3 days, 1-1.5days) which was statistically significant. Also 32 % patients with SIRS at admission had ICU admission compared to 4% of those without SIRS 10 . This study was conducted among adult patients and outcome analyzed was only for severity of disease after 48 hours and all patients with SIRS score 4 had severe pancreatitis.…”

Section: Discussionmentioning

confidence: 97%

Early identification of patients at risk of acute severe pancreatitis with Systemic Inflammatory Response Syndrome score at admission

Laudari

Thapa

Bohara

et al. 2019

J. Kathmandu Med. Coll.

View full text Add to dashboard Cite

Background: Clinically, the Systemic Inflammatory Response Syndrome (SIRS) is identified by two or more symptoms including fever or hypothermia, tachycardia, tachypnea and change in blood leukocyte count. The relationship between SIRS symptoms at the time of presentation and severity of pancreatitis is yet to be determined though progression of SIRS in subsequent days has already been correlated.Objectives: To determine the severity of pancreatitis with SIRS score at the time of admission.Methodology: A retrospective cohort study of patients admitted to Department of Surgery, Kathmandu Medical College Teaching Hospital (KMCTH) with diagnosis of Acute Pancreatitis (AP) from December 2014 to January 2016 was conducted. Clinical, biochemical and imaging data were collected from the medical record section. Patients with diagnosis of acute pancreatitis as per Revised Atlanta Classification 2012 were included in the study. SIRS score at time of admission was correlated with Modified Marshall scoring system for organ dysfunction. Patients were grouped into severe and nonsevere group. Sensitivity, specificity and predictive values of SIRS score at admission for organ failure were calculated.Results: Among the 41 patients admitted with diagnosis of acute pancreatitis irrespective of cause, the sensitivity of SIRS score ≥2 at admission in predicting severe pancreatitis was 60 %, specificity was 20%, positive predictive value was 28% and negative predictive value was 20 %, with p-value of 0.52 and odds ratio of 1.6 (CI: 0.376-6.808).Conclusion: SIRS score at admission cannot be solely used in predicting acute severe pancreatitis. Patients can be stratified in resource deficit setting for timely referral to tertiary centre.

show abstract

“…Most patients have mild episodes of AP, which resolve without complication, long-term symptoms, or recurrent episodes. Up to 30% of patients can experience local or systemic complications with morbidity and sometimes mortality [36,37]. Disease severity classifications were determined in 2017 by an expert panel and are determined by the presence or absence of local complications, transient (<48 h), or prolonged organ failure (>48 h) [36].…”

Section: Complicationsmentioning

confidence: 99%

Acute pancreatitis in children: risk factors, management, and outcomes

Mehta

2023

Current Opinion in Pediatrics

View full text Add to dashboard Cite

Purpose of review Pediatric acute pancreatitis is an infrequent but potentially serious condition in children. Most have mild cases with spontaneous resolution, but up to one-third of patients can have moderate or severe disease or progress to recurrent or chronic pancreatitis. Recent findings Significant advances have been made in the field of pediatric pancreatology with a recognition that pediatric acute pancreatitis can vary significantly from adult disease with different risk factors and outcomes. There is better understanding of appropriate management for pediatric pancreatitis as well as growing literature in complications of pancreatitis. Summary The most common risk factors for pediatric acute pancreatitis include biliary disease, drug/toxin and idiopathic. Management involves adequate fluid resuscitation, early enteral nutrition and appropriate pain control. Systemic and local complications, including SIRS, necrosis and fluid collections, can occur in up to one-third of patients and care is largely supportive with a careful step-up approach to fluid collections and necrosis.

show abstract

The Utility of the Systemic Inflammatory Respsonse Syndrome Score on Admission in Children With Acute Pancreatitis

Abstract: The presence of SIRS criteria on admission serves as a useful and easy-to-calculate predictor of increased LOS and admission to ICU in children with AP.

Cited by 16 publications

References 25 publications

Validation of Lipase and Systemic Inflammatory Response Syndrome as Prognostic Indicators in Pediatric Acute Pancreatitis

Validation of Lipase and Systemic Inflammatory Response Syndrome as Prognostic Indicators in Pediatric Acute Pancreatitis

Early identification of patients at risk of acute severe pancreatitis with Systemic Inflammatory Response Syndrome score at admission

Acute pancreatitis in children: risk factors, management, and outcomes

Contact Info

Product

Resources

About