November 12, 2014
Notes: Adam, Fusun
Turk J Gastroenterol. 2013;24(5):430-5.
Author Address: Ege University School of Medicine Hospital, Department of Anesthesiology, Izmir, Turkey.
Reference Type: Journal Article
Record Number: 4596Author: Ahmed, A., Gurjar, M., Poddar, B. and Azim, A.
Title: Undiagnosed diabetes presenting as hypertriglyceridemia-induced pancreatitis
Journal: Int J Crit Illn Inj Sci
Short Title: Undiagnosed diabetes presenting as hypertriglyceridemia-induced pancreatitis
Alternate Journal: International journal of critical illness and injury science
ISSN: 2229-5151 (Print)
Accession Number: 24404464
Notes: Ahmed, Armin
Int J Crit Illn Inj Sci. 2013 Jul;3(3):225-6. doi: 10.4103/2229-5151.119204.
Author Address: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh, India.
Reference Type: Journal Article
Record Number: 4597Author: Aitken, E. L., Gough, V., Jones, A. and Macdonald, A.
Title: Observational study of intra-abdominal pressure monitoring in acute pancreatitis
Short Title: Observational study of intra-abdominal pressure monitoring in acute pancreatitis
Alternate Journal: Surgery
ISSN: 1532-7361 (Electronic)
Accession Number: 24630146
Keywords: Acute Disease
Aged, 80 and over
Predictive Value of Tests
Sensitivity and Specificity
Abstract: BACKGROUND: Intra-abdominal hypertension (IAH) is predictive of adverse outcome in critically ill patients; however, its role in acute pancreatitis is unclear, and prospective studies are lacking. We aimed to determine the overall incidence and predictive value of IAH on mortality in acute pancreatitis. METHODS: Transvesical IAP was measured on admission and every 4 hours within high-dependency unit/intensive care unit. Serum biochemistry and physiologic parameters permitted calculation of Acute Physiology and Chronic Health Evaluation II, Sequential Organ Failure Assessment, Imrie, and Ranson scores. The primary end point was 30-day mortality. RESULTS: A total of 218 patients with acute pancreatitis were recruited; 30-day mortality was greater in patients with IAH (IAP >/=12 mmHg; 37%) than no IAH (2%; P < .001). A total of 14% of patients had IAH on admission; another 3% developed IAH in hospital. Mortality was greater in the latter group (37% vs 50%; P < .01). In the majority of cases IAH developed in line with other organ failure; however, there were several patients in whom the development of IAH appeared to be the sentinel event before rapid clinical decline. An IAP threshold of 9 mmHg had best predictive value for mortality (sensitivity 86%, specificity 87%; area under the ROC curve 0.91). This finding was comparable with other validated markers of severe pancreatitis (Imrie >/=3: sensitivity 51%, specificity 70%; Acute Physiology and Chronic Health Evaluation II: sensitivity 67%, specificity 96%; C-reactive protein >150: sensitivity 89%, specificity 83%). CONCLUSION: IAP is a good predictor of mortality and organ failure in acute pancreatitis and compares favorably with other validated prognostic scores. Whether IAH is a phenomenon causative of organ failure or an epiphenomenon, occurring in conjunction with other organ dysfunction, remains unclear.