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001-es BibID:	BIBFORM111659
035-os BibID:	(Scopus)85166916995
Első szerző:	Czapári Dóra
Cím:	Detailed characteristics of post-discharge mortality in acute pancreatitis / Dóra Czapári, Alex Váradi, Nelli Farkas, Gergely Nyári, Katalin Márta, Szilárd Váncsa, Rita Nagy, Brigitta Teutsch, Stefania Bunduc, Bálint Erőss, László Czakó, Áron Vincze, Ferenc Izbéki, Mária Papp, Béla Merkely, Andrea Szentesi, Peter Hegyi, Hungarian Pancreatic Study Group
Dátum:	2023
ISSN:	0016-5085
Megjegyzések:	Background and aims The in-hospital survival of patients suffering from acute pancreatitis (AP) is 95?98%. However, there is growing evidence that patients discharged after AP may be at risk of serious morbidity and mortality. Here, we aimed to investigate the risk, causes, and predictors of the most severe consequence of the post-AP period: mortality. Methods 2,613, well-characterized patients from twenty-five centers were collected and followed by the Hungarian Pancreatic Study Group between 2012 and 2021. A general and a hospital-based population was used as the control group. Results After an AP episode patients have an approximately three-fold higher incidence rate of mortality than the general population (0.0404 vs. 0.0130 person-years). First-year mortality after discharge was almost double than in-hospital mortality (5.5% vs. 3.5%), with 3.0% occurring in the first 90-day period. Age, comorbidities, and severity were the most significant independent risk factors for death following AP. Furthermore, multivariate analysis identified creatinine, glucose, and pleural fluid on admission as independent risk factors associated with post-discharge mortality. In the first 90-day period, cardiac failure and AP-related sepsis were among the main causes of death following discharge, while cancer-related cachexia and non-AP-related infection were the key causes in the later phase. Conclusion Almost as many patients in our cohort die in the first 90-day period after discharge asduring their hospital stay. Evaluation of cardiovascular status, follow-up of local complications, and cachexia-preventing oncological care should be an essential part of post-AP patient care. Future study protocols in AP must include at least a 90-day follow-up period after discharge.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Gastroenterology. - 165 : 3 (2023), p. 682-695. -
További szerzők:	Váradi Alex (1991-) (biológus) Farkas Nelli Nyári Gergely Róbert Márta Katalin Váncsa Szilárd Nagy Rita Teutsch Brigitta Bunduc, Stefania Erőss Bálint Czakó László Vincze Áron Izbéki Ferenc Papp Mária (1975-) (belgyógyász, gasztroenterológus) Merkely Béla (1965-) (orvos) Szentesi Andrea Hegyi Péter Jr. (belgyógyász) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Hungarian Pancreatic Study Group
Internet cím:	DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM136206
035-os BibID:	(wos)001710787300001
Első szerző:	Márta Katalin
Cím:	High versus gradually increasing energy nutrition in the early phase of acute pancreatitis (GOULASH) : a multicentre double-blind randomised clinical trial / Katalin Márta, Marie Anne Engh, Áron Vincze, Bálint Erőss, Péter J. Hegyi, Alexandra Mikó, Ferenc Izbéki, Mária Papp, Péter Mátrai, Zsolt Abonyi-Tóth, Nándor Faluhelyi, Andrea Szentesi, Péter Hegyi, the Goulash Trial Group
Dátum:	2026
ISSN:	0017-5749
Megjegyzések:	ABSTRACT Background Acute pancreatitis (AP) is among the most common gastrointestinal diseases requiring hospitalisation, often with severe outcomes and no disease-specific therapy. Nutritional support has been proven to improve outcome, but little is known regarding optimal timing and composition. Objective This clinical trial aimed to compare high (30 kcal/kg/day, high energy (HE)) versus gradually increasing energy (0 increased to 30 kcal/kg/day over 4 days, low energy (LE)) strategies for enteral nutritional support in AP. Design This was a multicentric, double-blind, randomised clinical trial, enrolling patients with AP regardless of predicted severity (January 2017 to April 2023). The primary outcome was a combination of mortality and severe acute pancreatitis (Revised Atlanta Criteria); secondary outcomes included severity, rate of infection, organ failure and pain relapse. Interim analysis was planned after 50% enrolment. The Benjamini-Hochberg false discovery rate (FDR) method was used to correct p value for multiple testing. Results The trial was stopped early after enrolling 636 patients. Interim analysis showed that the primary outcome showed no difference between groups in the modified intention-to-treat (mITT) population (HE: 28/312, 9.0% vs LE: 18/307, 5.7%, p(uncorrected/ corrected)=0.19/0.42). Secondary outcomes showed no difference in the mITT analysis. Without correction for multiplicity testing, results favoured a low gradual energy strategy in terms of organ failure (HE: 52/312, 16.7% vs LE: 28/307, 9.1%, p(uncorrected)=0.007) and pain relapse (80/312, 27.1% vs 54/307, 19.0% p(uncorrected)=0.03) but showed no differences between groups after correction for multiple testing (p=0.13 and p=0.23, respectively). It was determined that the superiority of the intervention would not be shown even with an increased sample size, and thus the trial was terminated based on a post hoc decision on ethics and futility. Conclusion Based on this early terminated trial, a high-energy strategy for early nutrition in pancreatitis does not decrease mortality/severity, but potentially increases organ failure and pain relapse rate.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Gut. - [Epub ahead of print] (2026). -
További szerzők:	Engh, Marie Anne Vincze Áron Erőss Bálint Hegyi Péter Jenő (belgyógyász) Mikó Alexandra Izbéki Ferenc Papp Mária (1975-) (belgyógyász, gasztroenterológus) Mátrai Péter Abonyi-Tóth Zsolt Faluhelyi Nándor Szentesi Andrea Hegyi Péter Jr. (belgyógyász) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Fehér Krisztina Eszter (1991-) (orvos) the Goulash Trial Group
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat DOI
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