Endoscopic management of hemorrhagic pancreatic fluid collections: A propensity‐matched analysis
Abstract Objectives Hemorrhagic pancreatic fluid collections (hPFC) are a complication of pancreatitis with an unknown influence on prognosis. Advancements in endoscopic management of PFC have improved results over their surgical and percutaneous alternatives. We performed a propensity‐matched analy...
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Wiley
2023-04-01
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| Online Access: | https://doi.org/10.1002/deo2.195 |
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| author | Rishi Pawa Robert Dorrell Greg Russell Madison Nguyen Clancy Clark Girish Mishra Swati Pawa |
| author_facet | Rishi Pawa Robert Dorrell Greg Russell Madison Nguyen Clancy Clark Girish Mishra Swati Pawa |
| author_sort | Rishi Pawa |
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| description | Abstract Objectives Hemorrhagic pancreatic fluid collections (hPFC) are a complication of pancreatitis with an unknown influence on prognosis. Advancements in endoscopic management of PFC have improved results over their surgical and percutaneous alternatives. We performed a propensity‐matched analysis comparing clinical outcomes in hemorrhagic and non‐hemorrhagic PFC (nhPFC). Methods From November 2015 to November 2021, a retrospective comparative cohort analysis was performed comparing clinical outcomes for patients with hPFC and nhPFC managed with lumen‐apposing metal stents. Propensity score matching was used to balance the two subgroups. Wilcoxon two‐sample tests were used to compare continuous variables and Fisher's exact test was used to compare categorical variables. Kaplan‐Meier method was used to estimate overall survival. Results Fifteen patients with hPFC were matched with 30 nhPFC patients. Technical and clinical success was similar in both groups. The median length of hospitalization was 6 days in the hPFC group and 3 days in the nhPFC group (p = 0.23); however, more hPFC patients required intensive care unit admission post‐procedure (33.3% vs. 16.7%, p = 0.26). Patients with hPFC were more likely to be readmitted to the hospital within 30 days (33.3% vs. 6.7%, p = 0.032). Mortality at 3 months (13% vs 3%, p = 0.25) and 6 months (27% vs. 7%, p = 0.09) was higher in the hPFC cohort. The 1‐year survival estimate was 73.3% (standard error = 11.4) in the hPFC group and 88.9% (6.1) in the nhPFC group (p = 0.16). Conclusions Patients with hPFC are more likely to be readmitted to the hospital within 30 days and have worse clinical outcomes. |
| format | Article |
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| language | English |
| publishDate | 2023-04-01 |
| publisher | Wiley |
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| spelling | doaj-art-dd7b9f75148e4d1e9a40b8f1a7f4be982025-08-20T02:31:29ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.195Endoscopic management of hemorrhagic pancreatic fluid collections: A propensity‐matched analysisRishi Pawa0Robert Dorrell1Greg Russell2Madison Nguyen3Clancy Clark4Girish Mishra5Swati Pawa6Department of Medicine Wake Forest University School of Medicine Winston‐Salem North Carolina USADepartment of Medicine Wake Forest University School of Medicine Winston‐Salem North Carolina USADepartment of Biostatistics and Data Science Wake Forest University School of Medicine Winston‐Salem North Carolina USADepartment of Medicine Virginia Commonwealth University Richmond Virginia USADepartment of General Surgery Wake Forest University School of Medicine Winston‐Salem North Carolina USADepartment of Medicine Wake Forest University School of Medicine Winston‐Salem North Carolina USADepartment of Medicine Wake Forest University School of Medicine Winston‐Salem North Carolina USAAbstract Objectives Hemorrhagic pancreatic fluid collections (hPFC) are a complication of pancreatitis with an unknown influence on prognosis. Advancements in endoscopic management of PFC have improved results over their surgical and percutaneous alternatives. We performed a propensity‐matched analysis comparing clinical outcomes in hemorrhagic and non‐hemorrhagic PFC (nhPFC). Methods From November 2015 to November 2021, a retrospective comparative cohort analysis was performed comparing clinical outcomes for patients with hPFC and nhPFC managed with lumen‐apposing metal stents. Propensity score matching was used to balance the two subgroups. Wilcoxon two‐sample tests were used to compare continuous variables and Fisher's exact test was used to compare categorical variables. Kaplan‐Meier method was used to estimate overall survival. Results Fifteen patients with hPFC were matched with 30 nhPFC patients. Technical and clinical success was similar in both groups. The median length of hospitalization was 6 days in the hPFC group and 3 days in the nhPFC group (p = 0.23); however, more hPFC patients required intensive care unit admission post‐procedure (33.3% vs. 16.7%, p = 0.26). Patients with hPFC were more likely to be readmitted to the hospital within 30 days (33.3% vs. 6.7%, p = 0.032). Mortality at 3 months (13% vs 3%, p = 0.25) and 6 months (27% vs. 7%, p = 0.09) was higher in the hPFC cohort. The 1‐year survival estimate was 73.3% (standard error = 11.4) in the hPFC group and 88.9% (6.1) in the nhPFC group (p = 0.16). Conclusions Patients with hPFC are more likely to be readmitted to the hospital within 30 days and have worse clinical outcomes.https://doi.org/10.1002/deo2.195drainageendoscopic ultrasonographyhemorrhagic pancreatitispseudoaneurysmself‐expandable metal stent |
| spellingShingle | Rishi Pawa Robert Dorrell Greg Russell Madison Nguyen Clancy Clark Girish Mishra Swati Pawa Endoscopic management of hemorrhagic pancreatic fluid collections: A propensity‐matched analysis DEN Open drainage endoscopic ultrasonography hemorrhagic pancreatitis pseudoaneurysm self‐expandable metal stent |
| title | Endoscopic management of hemorrhagic pancreatic fluid collections: A propensity‐matched analysis |
| title_full | Endoscopic management of hemorrhagic pancreatic fluid collections: A propensity‐matched analysis |
| title_fullStr | Endoscopic management of hemorrhagic pancreatic fluid collections: A propensity‐matched analysis |
| title_full_unstemmed | Endoscopic management of hemorrhagic pancreatic fluid collections: A propensity‐matched analysis |
| title_short | Endoscopic management of hemorrhagic pancreatic fluid collections: A propensity‐matched analysis |
| title_sort | endoscopic management of hemorrhagic pancreatic fluid collections a propensity matched analysis |
| topic | drainage endoscopic ultrasonography hemorrhagic pancreatitis pseudoaneurysm self‐expandable metal stent |
| url | https://doi.org/10.1002/deo2.195 |
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