Determinants of Severity in Acute Pancreatitis: A Nation-wide Multicenter Prospective Cohort Study

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Determinants of Severity in Acute Pancreatitis : A Nation-wide Multicenter Prospective Cohort Study. / Sternby, Hanna; Bolado, Federico; Canaval-Zuleta, Héctor J.; Marra-López, Carlos; Hernando-Alonso, Ana I.; Del-Val-Antoñana, Adolfo; García-Rayado, Guillermo; Rivera-Irigoin, Robin; Grau-García, Francisco J.; Oms, Lluís; Millastre-Bocos, Judith; Pascual-Moreno, Isabel; Martínez-Ares, David; Rodríguez-Oballe, Juan A.; López-Serrano, Antonio; Ruiz-Rebollo, María L.; Viejo-Almanzor, Alejandro; González-de-la-Higuera, Belén; Orive-Calzada, Aitor; Gómez-Anta, Ignacio; Pamies-Guilabert, José; Fernández-Gutiérrez-Del-Álamo, Fátima; Iranzo-González-Cruz, Isabel; Pérez-Muñante, Mónica E.; Esteba, María D.; Pardillos-Tomé, Ana; Zapater, Pedro; de-Madaria, Enrique.

In: Annals of Surgery, Vol. 270, No. 2, 2019, p. 348-355.

Research output: Contribution to journalArticle

Harvard

Sternby, H, Bolado, F, Canaval-Zuleta, HJ, Marra-López, C, Hernando-Alonso, AI, Del-Val-Antoñana, A, García-Rayado, G, Rivera-Irigoin, R, Grau-García, FJ, Oms, L, Millastre-Bocos, J, Pascual-Moreno, I, Martínez-Ares, D, Rodríguez-Oballe, JA, López-Serrano, A, Ruiz-Rebollo, ML, Viejo-Almanzor, A, González-de-la-Higuera, B, Orive-Calzada, A, Gómez-Anta, I, Pamies-Guilabert, J, Fernández-Gutiérrez-Del-Álamo, F, Iranzo-González-Cruz, I, Pérez-Muñante, ME, Esteba, MD, Pardillos-Tomé, A, Zapater, P & de-Madaria, E 2019, 'Determinants of Severity in Acute Pancreatitis: A Nation-wide Multicenter Prospective Cohort Study', Annals of Surgery, vol. 270, no. 2, pp. 348-355. https://doi.org/10.1097/SLA.0000000000002766

APA

Sternby, H., Bolado, F., Canaval-Zuleta, H. J., Marra-López, C., Hernando-Alonso, A. I., Del-Val-Antoñana, A., García-Rayado, G., Rivera-Irigoin, R., Grau-García, F. J., Oms, L., Millastre-Bocos, J., Pascual-Moreno, I., Martínez-Ares, D., Rodríguez-Oballe, J. A., López-Serrano, A., Ruiz-Rebollo, M. L., Viejo-Almanzor, A., González-de-la-Higuera, B., Orive-Calzada, A., ... de-Madaria, E. (2019). Determinants of Severity in Acute Pancreatitis: A Nation-wide Multicenter Prospective Cohort Study. Annals of Surgery, 270(2), 348-355. https://doi.org/10.1097/SLA.0000000000002766

CBE

Sternby H, Bolado F, Canaval-Zuleta HJ, Marra-López C, Hernando-Alonso AI, Del-Val-Antoñana A, García-Rayado G, Rivera-Irigoin R, Grau-García FJ, Oms L, Millastre-Bocos J, Pascual-Moreno I, Martínez-Ares D, Rodríguez-Oballe JA, López-Serrano A, Ruiz-Rebollo ML, Viejo-Almanzor A, González-de-la-Higuera B, Orive-Calzada A, Gómez-Anta I, Pamies-Guilabert J, Fernández-Gutiérrez-Del-Álamo F, Iranzo-González-Cruz I, Pérez-Muñante ME, Esteba MD, Pardillos-Tomé A, Zapater P, de-Madaria E. 2019. Determinants of Severity in Acute Pancreatitis: A Nation-wide Multicenter Prospective Cohort Study. Annals of Surgery. 270(2):348-355. https://doi.org/10.1097/SLA.0000000000002766

MLA

Vancouver

Sternby H, Bolado F, Canaval-Zuleta HJ, Marra-López C, Hernando-Alonso AI, Del-Val-Antoñana A et al. Determinants of Severity in Acute Pancreatitis: A Nation-wide Multicenter Prospective Cohort Study. Annals of Surgery. 2019;270(2):348-355. https://doi.org/10.1097/SLA.0000000000002766

Author

Sternby, Hanna ; Bolado, Federico ; Canaval-Zuleta, Héctor J. ; Marra-López, Carlos ; Hernando-Alonso, Ana I. ; Del-Val-Antoñana, Adolfo ; García-Rayado, Guillermo ; Rivera-Irigoin, Robin ; Grau-García, Francisco J. ; Oms, Lluís ; Millastre-Bocos, Judith ; Pascual-Moreno, Isabel ; Martínez-Ares, David ; Rodríguez-Oballe, Juan A. ; López-Serrano, Antonio ; Ruiz-Rebollo, María L. ; Viejo-Almanzor, Alejandro ; González-de-la-Higuera, Belén ; Orive-Calzada, Aitor ; Gómez-Anta, Ignacio ; Pamies-Guilabert, José ; Fernández-Gutiérrez-Del-Álamo, Fátima ; Iranzo-González-Cruz, Isabel ; Pérez-Muñante, Mónica E. ; Esteba, María D. ; Pardillos-Tomé, Ana ; Zapater, Pedro ; de-Madaria, Enrique. / Determinants of Severity in Acute Pancreatitis : A Nation-wide Multicenter Prospective Cohort Study. In: Annals of Surgery. 2019 ; Vol. 270, No. 2. pp. 348-355.

RIS

TY - JOUR

T1 - Determinants of Severity in Acute Pancreatitis

T2 - A Nation-wide Multicenter Prospective Cohort Study

AU - Sternby, Hanna

AU - Bolado, Federico

AU - Canaval-Zuleta, Héctor J.

AU - Marra-López, Carlos

AU - Hernando-Alonso, Ana I.

AU - Del-Val-Antoñana, Adolfo

AU - García-Rayado, Guillermo

AU - Rivera-Irigoin, Robin

AU - Grau-García, Francisco J.

AU - Oms, Lluís

AU - Millastre-Bocos, Judith

AU - Pascual-Moreno, Isabel

AU - Martínez-Ares, David

AU - Rodríguez-Oballe, Juan A.

AU - López-Serrano, Antonio

AU - Ruiz-Rebollo, María L.

AU - Viejo-Almanzor, Alejandro

AU - González-de-la-Higuera, Belén

AU - Orive-Calzada, Aitor

AU - Gómez-Anta, Ignacio

AU - Pamies-Guilabert, José

AU - Fernández-Gutiérrez-Del-Álamo, Fátima

AU - Iranzo-González-Cruz, Isabel

AU - Pérez-Muñante, Mónica E.

AU - Esteba, María D.

AU - Pardillos-Tomé, Ana

AU - Zapater, Pedro

AU - de-Madaria, Enrique

PY - 2019

Y1 - 2019

N2 - OBJECTIVE: The aim of this study was to compare and validate the different classifications of severity in acute pancreatitis (AP) and to investigate which characteristics of the disease are associated with worse outcomes. SUMMARY OF BACKGROUND DATA: AP is a heterogeneous disease, ranging from uneventful cases to patients with considerable morbidity and high mortality rates. Severity classifications based on legitimate determinants of severity are important to correctly describe the course of disease. METHODS: A prospective multicenter cohort study involving patients with AP from 23 hospitals in Spain. The Atlanta Classification (AC), Revised Atlanta Classification (RAC), and Determinant-based Classification (DBC) were compared. Binary logistic multivariate analysis was performed to investigate independent determinants of severity. RESULTS: A total of 1655 patients were included; 70 patients (4.2%) died. RAC and DBC were equally superior to AC for describing the clinical course of AP. Although any kind of organ failure was associated with increased morbidity and mortality, persistent organ failure (POF) was the most significant determinant of severity. All local complications were associated with worse outcomes. Infected pancreatic necrosis correlated with high morbidity, but in the presence of POF, it was not associated to higher mortality when compared with sterile necrotizing pancreatitis. Exacerbation of previous comorbidity was associated with increased morbidity and mortality. CONCLUSION: The RAC and DBC both signify an advance in the description and differentiation of AP patients. Herein, we describe the complications of the disease independently associated to morbidity and mortality. Our findings are valuable not only when designing future studies on AP but also for the improvement of current classifications.

AB - OBJECTIVE: The aim of this study was to compare and validate the different classifications of severity in acute pancreatitis (AP) and to investigate which characteristics of the disease are associated with worse outcomes. SUMMARY OF BACKGROUND DATA: AP is a heterogeneous disease, ranging from uneventful cases to patients with considerable morbidity and high mortality rates. Severity classifications based on legitimate determinants of severity are important to correctly describe the course of disease. METHODS: A prospective multicenter cohort study involving patients with AP from 23 hospitals in Spain. The Atlanta Classification (AC), Revised Atlanta Classification (RAC), and Determinant-based Classification (DBC) were compared. Binary logistic multivariate analysis was performed to investigate independent determinants of severity. RESULTS: A total of 1655 patients were included; 70 patients (4.2%) died. RAC and DBC were equally superior to AC for describing the clinical course of AP. Although any kind of organ failure was associated with increased morbidity and mortality, persistent organ failure (POF) was the most significant determinant of severity. All local complications were associated with worse outcomes. Infected pancreatic necrosis correlated with high morbidity, but in the presence of POF, it was not associated to higher mortality when compared with sterile necrotizing pancreatitis. Exacerbation of previous comorbidity was associated with increased morbidity and mortality. CONCLUSION: The RAC and DBC both signify an advance in the description and differentiation of AP patients. Herein, we describe the complications of the disease independently associated to morbidity and mortality. Our findings are valuable not only when designing future studies on AP but also for the improvement of current classifications.

KW - surgery

KW - acute pancreatitis

U2 - 10.1097/SLA.0000000000002766

DO - 10.1097/SLA.0000000000002766

M3 - Article

C2 - 29672416

AN - SCOPUS:85069853470

VL - 270

SP - 348

EP - 355

JO - Annals of Surgery

JF - Annals of Surgery

SN - 1528-1140

IS - 2

ER -