Assessment of the course of acute pancreatitis in the light of aetiology: a systematic review and meta-analysis

被引:59
作者
Balint, Emese Reka [1 ]
Fur, Gabriella [1 ]
Kiss, Lorand [1 ]
Nemeth, David Istvan [2 ,3 ]
Soos, Alexandra [2 ,3 ,5 ]
Hegyi, Peter [2 ,3 ,4 ]
Szakacs, Zsolt [2 ,3 ]
Tinusz, Benedek [2 ,3 ]
Varju, Peter [6 ]
Vincze, Aron [6 ]
Eross, Balint [2 ,3 ]
Czimmer, Jozsef [2 ,3 ]
Szepes, Zoltan [7 ]
Varga, Gabor [8 ]
Rakonczay, Zoltan, Jr. [1 ]
机构
[1] Univ Szeged, Dept Pathophysiol, Szeged, Hungary
[2] Univ Pecs, Inst Translat Med, Pecs, Hungary
[3] Univ Pecs, Szentagothai Res Ctr, Pecs, Hungary
[4] MTA SZTE Momentum Translat Gastroenterol Res Grp, Szeged, Hungary
[5] Univ Szeged, Clin Med Doctoral Sch, Szeged, Hungary
[6] Univ Pecs, Dept Med 1, Pecs, Hungary
[7] Univ Szeged, Dept Med 1, Szeged, Hungary
[8] Semmelweis Univ, Dept Oral Biol, Budapest, Hungary
关键词
PERSISTENT ORGAN FAILURE; ELEVATED SERUM TRIGLYCERIDES; RECURRENT ACUTE-PANCREATITIS; REVISED ATLANTA CLASSIFICATION; BODY-MASS INDEX; RISK-FACTORS; EARLY PREDICTION; 1ST ATTACK; CLINICAL-FEATURES; DISEASE SEVERITY;
D O I
10.1038/s41598-020-74943-8
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
The main causes of acute pancreatitis (AP) are biliary disease, alcohol consumption, hypertriglyceridaemia (HTG) and endoscopic retrograde cholangiopancreatography (ERCP). The aim of this meta-analysis was to evaluate the effects of these aetiological factors on the severity and outcome of AP. Pubmed and Embase were searched between 01/01/2012 and 31/05/2020. Included articles involved adult alcoholic, biliary, HTG- or post-ERCP AP (PAP) patients. Primary outcome was severity, secondary outcomes were organ failures, intensive care unit admission, recurrence rate, pancreatic necrosis, mortality, length of hospital stay, pseudocyst, fluid collection and systematic inflammatory response syndrome. Data were analysed from 127 eligible studies. The risk for non-mild (moderately severe and severe) condition was the highest in HTG-induced AP (HTG-AP) followed by alcoholic AP (AAP), biliary AP (BAP) and PAP. Recurrence rate was significantly lower among BAP vs. HTG-AP or AAP patients (OR=2.69 and 2.98, 95% CI 1.55-4.65 and 2.22-4.01, respectively). Mortality rate was significantly greater in HTG-AP vs. AAP or BAP (OR=1.72 and 1.50, 95% CI 1.04-2.84 and 0.96-2.35, respectively), pancreatic necrosis occurred more frequently in AAP than BAP patients (OR=1.58, 95% CI 1.08-2.30). Overall, there is a potential association between aetiology and the development and course of AP. HTG-AP is associated with the highest number of complications. Furthermore, AAP is likely to be more severe than BAP or PAP. Greater emphasis should be placed on determining aetiology on admission.
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页数:17
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