Increased Mortality from Extrapancreatic Infections in Hospitalized Patients with Acute Pancreatitis
Nosocomial extrapancreatic infections in patients with acute pancreatitis (AP) are associated with a higher mortality even after adjusting the risk for the severity of the pancreatitis. The aim of this study was to describe the clinical features of hospitalized patients with AP who died during their...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/2789764 |
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| author | Guido Grajales-Figueroa Héctor Adrián Díaz Hernández Martín Alejandro Chacón Portillo Luis F. Uscanga Mario Peláez-Luna Jorge Hernández Calleros |
| author_facet | Guido Grajales-Figueroa Héctor Adrián Díaz Hernández Martín Alejandro Chacón Portillo Luis F. Uscanga Mario Peláez-Luna Jorge Hernández Calleros |
| author_sort | Guido Grajales-Figueroa |
| collection | DOAJ |
| description | Nosocomial extrapancreatic infections in patients with acute pancreatitis (AP) are associated with a higher mortality even after adjusting the risk for the severity of the pancreatitis. The aim of this study was to describe the clinical features of hospitalized patients with AP who died during their hospitalization and to evaluate risk factors associated with mortality. We performed a descriptive study of the clinical features of adult patients who died from AP during their hospitalization and a case control study with a paired group of patients that survived AP during a 10-year period. Data of interest were collected from the medical records and are presented with appropriate measures of central tendency and dispersion. For the case control study, the primary outcome evaluated was death, and to evaluate associated clinical features and determine differences between groups, we performed the χ2 or Fisher’s exact tests for categorical variables and the Student t-test or Mann-Whitney U test for continuous variables as appropriate. We found 48 patients with acute pancreatitis who died within the period of the study during hospitalization; from these, 50% were men, mean age was 53.2 years, and the most common etiology was biliary obstruction by gallstones in 45.8%. The global mortality rate was of 2.5%. A total of 43.7% patients had infected pancreatic necrosis, and in 58.3%, some extrapancreatic infection was documented, being the most common urinary tract infection in 50%, bacteremia in 50% and pneumonia in 33.3%. Clinical features associated with mortality were the presence of organ failure (p<0.001), nosocomial complications (p<0.001), infected necrosis (p<0.001), and extrapancreatic infections (p=0.002). From the different extrapancreatic infections, only bacteremia (p=0.001) and pneumonia (p=0.011) were associated with higher mortality. In conclusion, extrapancreatic infections are associated with increased mortality among hospitalized patients with acute pancreatitis, in particular, bacteremia and pneumonia with an isolated pathogen. |
| format | Article |
| id | doaj-art-e0ddc3ec36b54365bddd1a1dfed1b961 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-e0ddc3ec36b54365bddd1a1dfed1b9612025-02-03T01:29:16ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/27897642789764Increased Mortality from Extrapancreatic Infections in Hospitalized Patients with Acute PancreatitisGuido Grajales-Figueroa0Héctor Adrián Díaz Hernández1Martín Alejandro Chacón Portillo2Luis F. Uscanga3Mario Peláez-Luna4Jorge Hernández Calleros5National Institute of Medical Science and Nutrition Salvador Zubiran, Department of Endoscopy, Mexico City, MexicoNational Institute of Medical Science and Nutrition Salvador Zubiran, Department of Gastroenterology, Mexico City, MexicoDivision of Congenital Heart Surgery, Texas Children’s Hospital, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USANational Institute of Medical Science and Nutrition Salvador Zubiran, Department of Gastroenterology, Mexico City, MexicoNational Institute of Medical Science and Nutrition Salvador Zubiran, Department of Gastroenterology, Mexico City, MexicoNational Institute of Medical Science and Nutrition Salvador Zubiran, Department of Gastroenterology, Mexico City, MexicoNosocomial extrapancreatic infections in patients with acute pancreatitis (AP) are associated with a higher mortality even after adjusting the risk for the severity of the pancreatitis. The aim of this study was to describe the clinical features of hospitalized patients with AP who died during their hospitalization and to evaluate risk factors associated with mortality. We performed a descriptive study of the clinical features of adult patients who died from AP during their hospitalization and a case control study with a paired group of patients that survived AP during a 10-year period. Data of interest were collected from the medical records and are presented with appropriate measures of central tendency and dispersion. For the case control study, the primary outcome evaluated was death, and to evaluate associated clinical features and determine differences between groups, we performed the χ2 or Fisher’s exact tests for categorical variables and the Student t-test or Mann-Whitney U test for continuous variables as appropriate. We found 48 patients with acute pancreatitis who died within the period of the study during hospitalization; from these, 50% were men, mean age was 53.2 years, and the most common etiology was biliary obstruction by gallstones in 45.8%. The global mortality rate was of 2.5%. A total of 43.7% patients had infected pancreatic necrosis, and in 58.3%, some extrapancreatic infection was documented, being the most common urinary tract infection in 50%, bacteremia in 50% and pneumonia in 33.3%. Clinical features associated with mortality were the presence of organ failure (p<0.001), nosocomial complications (p<0.001), infected necrosis (p<0.001), and extrapancreatic infections (p=0.002). From the different extrapancreatic infections, only bacteremia (p=0.001) and pneumonia (p=0.011) were associated with higher mortality. In conclusion, extrapancreatic infections are associated with increased mortality among hospitalized patients with acute pancreatitis, in particular, bacteremia and pneumonia with an isolated pathogen.http://dx.doi.org/10.1155/2019/2789764 |
| spellingShingle | Guido Grajales-Figueroa Héctor Adrián Díaz Hernández Martín Alejandro Chacón Portillo Luis F. Uscanga Mario Peláez-Luna Jorge Hernández Calleros Increased Mortality from Extrapancreatic Infections in Hospitalized Patients with Acute Pancreatitis Gastroenterology Research and Practice |
| title | Increased Mortality from Extrapancreatic Infections in Hospitalized Patients with Acute Pancreatitis |
| title_full | Increased Mortality from Extrapancreatic Infections in Hospitalized Patients with Acute Pancreatitis |
| title_fullStr | Increased Mortality from Extrapancreatic Infections in Hospitalized Patients with Acute Pancreatitis |
| title_full_unstemmed | Increased Mortality from Extrapancreatic Infections in Hospitalized Patients with Acute Pancreatitis |
| title_short | Increased Mortality from Extrapancreatic Infections in Hospitalized Patients with Acute Pancreatitis |
| title_sort | increased mortality from extrapancreatic infections in hospitalized patients with acute pancreatitis |
| url | http://dx.doi.org/10.1155/2019/2789764 |
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