Acute pancreatitis in Turkey: Results of a nationwide multicenter study
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Date
2024
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Abstract
Background: Acute pancreatitis (AP) is the most common gastrointestinal disease requiring hospitalization, with significant mortality and morbidity. We aimed to evaluate the clinical characteristics of AP and physicians’ compliance with international guidelines during its management. Methods: All patients with AP who were hospitalized at 17 tertiary centers in Turkey between April and October 2022 were evaluated in a prospective cohort study. Patients with insufficient data, COVID-19 and those aged below 18 years were excluded. The definitions were based on the 2012 revised Atlanta criteria. Results: The study included 2144 patients (median age:58, 52 % female). The most common etiologies were biliary (n = 1438, 67.1 %), idiopathic (n = 259, 12 %), hypertriglyceridemia (n = 128, 6 %) and alcohol (n = 90, 4.2 %). Disease severity was mild in 1567 (73.1 %), moderate in 521 (24.3 %), and severe in 58 (2.6 %) patients. Morphology was necrotizing in 4.7 % of the patients. The overall mortality rate was 1.6 %. PASS and BISAP had the highest accuracy in predicting severe pancreatitis on admission (AUC:0.85 and 0.81, respectively). CT was performed in 61 % of the patients, with the majority (90 %) being within 72 h after admission. Prophylactic NSAIDs were not administered in 44 % of the patients with post-ERCP pancreatitis (n = 86). Antibiotics were administered to 53.7 % of the patients, and 38 % of those received them prophylactically. Conclusions: This prospective study provides an extensive report on clinical characteristics, management and outcomes of AP in real-world practice. Mortality remains high in severe cases and physicians’ adherence to guidelines during management of the disease needs improvement in some aspects. © 2023 IAP and EPC
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Acute Disease , Aged , Female , Humans , Male , Pancreatitis , Prospective Studies , Retrospective Studies , Severity of Illness Index , Turkey , amylase , analgesic agent , antibiotic agent , antihypertensive agent , azathioprine , bilirubin , C reactive protein , creatinine , erythromycin estolate , glucose , nitrogen , nonsteroid antiinflammatory agent , oral antidiabetic agent , triacylglycerol lipase , urea , abdominal pain , accuracy , acute hemorrhagic pancreatitis , acute pancreatitis , adult , aged , amylase blood level , antibiotic therapy , Article , bilirubin blood level , body mass , cardiovascular disease , cerebrovascular accident , chronic kidney failure , chronic obstructive lung disease , clinical feature , cohort analysis , colon ischemia , common bile duct stone , computer assisted tomography , creatinine blood level , current smoker , diabetes mellitus , disease severity , false aneurysm , female , fever , heart failure , hospital admission , hospitalization , human , hypertension , hypertriglyceridemia , kidney failure , laboratory test , leukocyte count , major clinical study , male , medical history , medical record review , mortality , mortality rate , multicenter study , obesity , observational study , obstructive jaundice , pancreas necrosis , patient history of cholecystectomy , percutaneous drainage , prospective study , pylorus stenosis , respiratory failure , sex difference , splanchnic vein thrombosis , triacylglycerol level , triacylglycerol lipase blood level , Turkey (republic) , urea nitrogen blood level , acute disease , clinical trial , pancreatitis , retrospective study , severity of illness index , turkey (bird)