PMID- 33429393
OWN - NLM
STAT- MEDLINE
DCOM- 20210521
LR  - 20210521
IS  - 1421-9875 (Electronic)
IS  - 0257-2753 (Linking)
VI  - 39
IP  - 3
DP  - 2021
TI  - Development of an Online App to Predict Post-Endoscopic Retrograde 
      Cholangiopancreatography Adverse Events Using a Single-Center Retrospective 
      Cohort.
PG  - 283-293
LID - 10.1159/000514279 [doi]
AB  - INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is a 
      technically demanding procedure with a high risk for adverse events (AEs). AIM: 
      evaluate patient- and procedure-related risk factors for ERCP-related AEs and 
      develop an online app to estimate risk of AEs. METHODS: retrospective study of 
      1,491 consecutive patients who underwent 1,991 ERCPs between 2012 and 2017 was 
      conducted. AEs definition and severity were classified according to most recent 
      ESGE guidelines. Each variable was tested for association with occurrence of 
      overall AEs, post-ERCP pancreatitis (PEP) and cholangitis. For each outcome, 2 
      regression models were built, from which an online Shiny-based app was created. 
      RESULTS: Overall AE rate was 15.3%; in 19 procedures, >1 AE occurred. Main 
      post-ERCP AE was PEP (7.5%), followed by cholangitis (4.9%), bleeding (1.3%), 
      perforation (1%), cardiopulmonary events (0.9%), and cholecystitis (0.3%). 
      Seventy-eight percent of AEs were mild/moderate; of severe (n = 55) and fatal (n 
      = 20) AEs, more than half were related to infection, cardiac/pulmonary AEs, and 
      perforation. AE-related mortality rate was 1%. When testing precannulation, 
      procedural covariates, and ERCP findings, AE occurrence was associated with age 
      (odds ratio [OR] 0.991), previous PEP (OR 2.198), ERCP complexity grade III/IV 
      (OR 1.924), standard bile duct cannulation (OR 0.501), sphincterotomy (OR 1.441), 
      metal biliary stent placement (OR 2.014), periprocedural bleeding (OR 3.024), and 
      biliary duct lithiasis (OR 0.673). CONCLUSION: Our app may allow an optimization 
      of the patients' care, by helping in the process of decision-making, not only 
      regarding patient or endoscopist's selection but also definition of an adequate 
      and tailored surveillance plan after the procedure.
CI  - (c) 2021 S. Karger AG, Basel.
FAU - Rodrigues-Pinto, Eduardo
AU  - Rodrigues-Pinto E
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Morais, Rui
AU  - Morais R
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Sousa-Pinto, Bernardo
AU  - Sousa-Pinto B
AD  - MEDCIDS - Department of Community Medicine, Information and Health Decision 
      Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
AD  - CINTESIS - Center for Health Technology and Services Research, Porto, Portugal.
FAU - Ferreira da Silva, Joel
AU  - Ferreira da Silva J
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Costa-Moreira, Pedro
AU  - Costa-Moreira P
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Santos, Ana L
AU  - Santos AL
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Silva, Marco
AU  - Silva M
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Coelho, Rosa
AU  - Coelho R
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Gaspar, Rui
AU  - Gaspar R
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Peixoto, Armando
AU  - Peixoto A
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Dias, Emanuel
AU  - Dias E
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Baron, Todd H
AU  - Baron TH
AD  - Division of Gastroenterology and Hepatology, University of North Carolina, Chapel 
      Hill, North Carolina, USA.
FAU - Vilas-Boas, Filipe
AU  - Vilas-Boas F
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Moutinho-Ribeiro, Pedro
AU  - Moutinho-Ribeiro P
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Pereira, Pedro
AU  - Pereira P
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
FAU - Macedo, Guilherme
AU  - Macedo G
AD  - Gastroenterology Department, Centro Hospitalar Sao Joao, Porto, Portugal.
LA  - eng
PT  - Journal Article
DEP - 20210111
PL  - Switzerland
TA  - Dig Dis
JT  - Digestive diseases (Basel, Switzerland)
JID - 8701186
SB  - IM
MH  - Aged
MH  - Cholangiopancreatography, Endoscopic Retrograde/*adverse effects/mortality
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Mobile Applications
MH  - Odds Ratio
MH  - Postoperative Complications/etiology
MH  - Retrospective Studies
MH  - Risk Factors
OTO - NOTNLM
OT  - Adverse events
OT  - Cholangitis
OT  - Endoscopic retrograde cholangiopancreatography
OT  - Post-endoscopic retrograde cholangiopancreatography pancreatitis
EDAT- 2021/01/12 06:00
MHDA- 2021/05/22 06:00
CRDT- 2021/01/11 20:17
PHST- 2020/09/28 00:00 [received]
PHST- 2021/01/10 00:00 [accepted]
PHST- 2021/01/12 06:00 [pubmed]
PHST- 2021/05/22 06:00 [medline]
PHST- 2021/01/11 20:17 [entrez]
AID - 000514279 [pii]
AID - 10.1159/000514279 [doi]
PST - ppublish
SO  - Dig Dis. 2021;39(3):283-293. doi: 10.1159/000514279. Epub 2021 Jan 11.