PMID- 34503931
OWN - NLM
STAT- MEDLINE
DCOM- 20220208
LR  - 20220208
IS  - 1878-3562 (Electronic)
IS  - 1590-8658 (Linking)
VI  - 53
IP  - 12
DP  - 2021 Dec
TI  - Synchronous organ failure and infected pancreatic necrosis define genuine 
      critical acute pancreatitis.
PG  - 1590-1595
LID - S1590-8658(21)00732-5 [pii]
LID - 10.1016/j.dld.2021.08.016 [doi]
AB  - BACKGROUND: Critical acute pancreatitis (CAP) was supposed to be strongly 
      associated with the highest risk of adverse outcomes. However, the definition of 
      CAP needs to be further clarified. METHODS: A prospective database with 
      consecutive patients of infected pancreatic necrosis (IPN) at a tertiary hospital 
      was post-hoc analyzed. Patients were assigned to IPN alone, Metachronous-CAP 
      (MCAP) and Synchronous-CAP group (SCAP) according to presence or absence of organ 
      failure (OF) and the crosstalk between OF and IPN. Clinical interventions and 
      outcomes were compared among groups. RESULTS: A total of 248 IPN patients were 
      enrolled and the overall mortality was 25.8%. Compared with MCAP, SCAP was 
      associated with higher mortality (66.2 versus 10.0%) and morbidity (41.2 versus 
      18.0%), longer duration of OF (median 35.5 versus 12.0 days), ICU length of stay 
      (LOS) (median 28.0 versus 16.0 days) and hospital LOS (median 67.0 versus 60.0 
      days) (all P < 0.05). The IPN alone and MCAP had comparable mortality (10.8 
      versus 10.0%), morbidity and hospital LOS, except that MCAP patients were 
      characterized with longer duration of OF and ICU LOS (P < 0.05). CONCLUSIONS: 
      SCAP, characterized with synchronous persistent OF and IPN, was associated with 
      higher mortality and morbidity and should be defined as genuine CAP.
CI  - Copyright (c) 2021. Published by Elsevier Ltd.
FAU - Shen, Dingcheng
AU  - Shen D
AD  - Department of Pancreatic Surgery, General Surgery, Xiangya Hospital, Central 
      South University, 87 Xiangya Road, Changsha, Hunan Province 410008, China; 
      National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha 410008, China.
FAU - Wei, Qin
AU  - Wei Q
AD  - Department of Pancreatic Surgery, General Surgery, Xiangya Hospital, Central 
      South University, 87 Xiangya Road, Changsha, Hunan Province 410008, China; 
      National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha 410008, China.
FAU - Huang, Haosu
AU  - Huang H
AD  - Department of Gastroenterology, Xiangya Hospital, Central South University, 
      Changsha, Hunan Province 410008, China.
FAU - Ning, Caihong
AU  - Ning C
AD  - Department of Pancreatic Surgery, General Surgery, Xiangya Hospital, Central 
      South University, 87 Xiangya Road, Changsha, Hunan Province 410008, China; 
      National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha 410008, China.
FAU - Li, Jiarong
AU  - Li J
AD  - Department of Pancreatic Surgery, General Surgery, Xiangya Hospital, Central 
      South University, 87 Xiangya Road, Changsha, Hunan Province 410008, China; 
      National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha 410008, China.
FAU - Chen, Lu
AU  - Chen L
AD  - Department of Pancreatic Surgery, General Surgery, Xiangya Hospital, Central 
      South University, 87 Xiangya Road, Changsha, Hunan Province 410008, China; 
      National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha 410008, China.
FAU - Zhu, Shuai
AU  - Zhu S
AD  - Department of Pancreatic Surgery, General Surgery, Xiangya Hospital, Central 
      South University, 87 Xiangya Road, Changsha, Hunan Province 410008, China; 
      National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha 410008, China.
FAU - Huang, Gengwen
AU  - Huang G
AD  - Department of Pancreatic Surgery, General Surgery, Xiangya Hospital, Central 
      South University, 87 Xiangya Road, Changsha, Hunan Province 410008, China; 
      National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, 
      Central South University, Changsha 410008, China. Electronic address: 
      huanggengwen@csu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20210906
PL  - Netherlands
TA  - Dig Liver Dis
JT  - Digestive and liver disease : official journal of the Italian Society of 
      Gastroenterology and the Italian Association for the Study of the Liver
JID - 100958385
SB  - IM
CIN - Dig Liver Dis. 2021 Dec;53(12):1588-1589. PMID: 34583906
MH  - Adult
MH  - Female
MH  - Humans
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Multiple Organ Failure/etiology/*mortality
MH  - Pancreatitis, Acute Necrotizing/*mortality
MH  - Prospective Studies
MH  - Risk Assessment
OTO - NOTNLM
OT  - Critical acute pancreatitis
OT  - Infected pancreatic necrosis
OT  - Organ failure
OT  - Synchronous
COIS- Conflict of Interest The authors declare that they have no competing interests.
EDAT- 2021/09/11 06:00
MHDA- 2022/02/09 06:00
CRDT- 2021/09/10 05:47
PHST- 2021/07/13 00:00 [received]
PHST- 2021/08/13 00:00 [revised]
PHST- 2021/08/17 00:00 [accepted]
PHST- 2021/09/11 06:00 [pubmed]
PHST- 2022/02/09 06:00 [medline]
PHST- 2021/09/10 05:47 [entrez]
AID - S1590-8658(21)00732-5 [pii]
AID - 10.1016/j.dld.2021.08.016 [doi]
PST - ppublish
SO  - Dig Liver Dis. 2021 Dec;53(12):1590-1595. doi: 10.1016/j.dld.2021.08.016. Epub 
      2021 Sep 6.