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001-es BibID:	BIBFORM082673
035-os BibID:	(cikkazonosító)1092 (WoS)000483784200001 (Scopus)85072948362
Első szerző:	Farkas Nelli
Cím:	A Multicenter, International Cohort Analysis of 1435 Cases to Support Clinical Trial Design in Acute Pancreatitis / Nelli Farkas, Lilla Hanák, Alexandra Mikó, Judit Bajor, Patrícia Sarlós, József Czimmer, Áron Vincze, Szilárd Gódi, Dániel Pécsi, Péter Varjú, Katalin Márta, Péter Jenő Hegyi, Bálint Erőss, Zsolt Szakács, Tamás Takács, László Czakó, Balázs Németh, Dóra Illés, Balázs Kui, Erika Darvasi, Ferenc Izbéki, Adrienn Halász, Veronika Dunás-Varga, László Gajdán, József Hamvas, Mária Papp, Ildikó Földi, Krisztina Eszter Fehér, Márta Varga, Klára Csefkó, Imola Török, Farkas Hunor-Pál, Artautas Mickevicius, Elena Ramirez Maldonado, Ville Sallinen, János Novák, Ali Tüzün Ince, Shamil Galeev, Barnabás Bod, János Sümegi, Petr Pencik, Attila Szepes, Andrea Szentesi, Andrea Párniczky, Péter Jr. Hegyi, Hungarian Pancreatic Study Group
Dátum:	2019
ISSN:	1664-042X
Megjegyzések:	Background: C-reactive protein level (CRP) and white blood cell count (WBC) have been variably used in clinical trials on acute pancreatitis (AP). We assessed their potential role. Methods: First, we investigated studies which have used CRP or WBC, to describe their current role in trials on AP. Second, we extracted the data of 1435 episodes of AP from our registry. CRP and WBC on admission, within 24 h from the onset of pain and their highest values were analyzed. Descriptive statistical tools as Kruskal?Wallis, Mann? Whitney U, Levene's F tests, Receiver Operating Characteristic (ROC) curve analysis and AUC (Area Under the Curve) with 95% confidence interval (CI) were performed. Results: Our literature review showed extreme variability of CRP used as an inclusion criterion or as a primary outcome or both in past and current trials on AP. In our cohort, CRP levels on admission poorly predicted mortality and severe cases of AP; AUC: 0.669 (CI:0.569?0.770); AUC:0.681 (CI: 0.601?0.761), respectively. CRP levels measured within 24 h from the onset of pain failed to predict mortality or severity; AUC: 0.741 (CI:0.627?0.854); AUC:0.690 (CI:0.586?0.793), respectively. The highest CRP during hospitalization had equally poor predictive accuracy for mortality and severity AUC:0.656 (CI:0.544?0.768); AUC:0.705 (CI:0.640?0.769) respectively. CRP within 24 h from the onset of pain used as an inclusion criterion markedly increased the combined event rate of mortality and severe AP (13% for CRP > 25 mg/l and 28% for CRP > 200 mg/l). Conclusion: CRP within 24 h from the onset of pain as an inclusion criterion elevates event rates and reduces the number of patients required in trials on AP.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk acute pancreatitis C-reactive protein white blood cell trial design sample size calculation
Megjelenés:	Frontiers in Physiology. - 10 (2019), p. 1-12. -
További szerzők:	Hanák Lilla Mikó Alexandra Bajor Judit Sarlós Patrícia Czimmer József Vincze Áron Gódi Szilárd Pécsi Dániel Varjú Péter Márta Katalin Hegyi Péter Jenő (belgyógyász) Erőss Bálint Szakács Zsolt Takács Tamás (Szeged) Czakó László Németh Balázs Tamás Illés Dóra Kui Balázs Darvasi Erika Izbéki Ferenc Halász Adrienn Dunás-Varga Veronika Gajdán László Hamvas József Papp Mária (1975-) (belgyógyász, gasztroenterológus) Földi Ildikó (1981-) (orvos) Fehér Krisztina Eszter Varga Márta Csefkó Klára Török Imola Farkas Hunor Mickevicius, Artautas Maldonado, Elena Ramirez Sallinen, Ville Novák János Ince, Ali Tüzün Galeev, Shamil Bod Barnabás Sümegi János Pencik, Petr Szepes Attila (Szeged) Szentesi Andrea Párniczky Andrea (gyermekgyógyász) Hegyi Péter Jr. (belgyógyász) Hungarian Pancreatic Study Group
Pályázati támogatás:	GINOP 2.3.2-15-2016-00048 GINOP EFOP-3.6.2-16-2017-00006 EFOP
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001-es BibID:	BIBFORM076218
035-os BibID:	(cikkazonosító)1776 (WoS)000463100200001 (Scopus)85068267109
Első szerző:	Szakács Zsolt
Cím:	Aging and Comorbidities in Acute Pancreatitis II. : a Cohort-analysis of 1203 Prospectively Collected Cases / Zsolt Szakács, Noémi Gede, Dániel Pécsi, Ferenc Izbéki, Mária Papp, György Kovács, Eszter Fehér, Dalma Dobszai, Balázs Kui, Katalin Márta, Klára Kónya, Imre Szabó, Imola Török, László Gajdán, Tamás Takács, Patrícia Sarlós, Szilárd Gódi, Márta Varga, József Hamvas, Áron Vincze, Andrea Szentesi, Andrea Párniczky, Peter Hegyi
Dátum:	2019
Megjegyzések:	Introduction: Our meta-analysis indicated that aging influences the outcomes of acute pancreatitis (AP), however, a potential role for comorbidities was implicated, as well. Here we aimed to determine how age and comorbidities modify the outcomes in AP in a cohort-analysis of Hungarian AP cases. Materials and methods: Data of patients diagnosed with AP by the revised Atlanta criteria were extracted from the Hungarian National Pancreas Registry. Outcomes of interest were mortality, severity, length of hospitalization, local, and systemic complications of AP. Comorbidities were measured by means of Charlson Comorbidity Index (CCI) covering pre-existing chronic conditions. Non-parametric univariate and multivariate statistics were used in statistical analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: A total of 1203 patients from 18 centers were included. Median age at admission was 58 y (range: 18-95 y), median CCI was 2 (range: 0-10). Only severe comorbidities (CCI?3) predicted mortality (OR=4.48; CI: 1.57-12.80). Although severe comorbidities predicted AP severity (OR=2.10, CI: 1.08-4.09), middle (35-64 years) and old age (?65 years) were strong predictors with borderline significance, as well (OR=7.40, CI: 0.99-55.31 and OR=6.92, CI: 0.91-52.70, respectively). Similarly, middle and old age predicted a length of hospitalization ?9 days. Interestingly, the middle-aged (35-64 years) were three times more likely to develop pancreatic necrosis than young adults (OR=3.21, CI: 1.26-8.19), whereas the old-aged (?65 years) were almost nine times more likely to develop systemic complications than young adults (OR=8.93, CI: 1.20-66.80), though having severe comorbidities (CCI?3) was a predisposing factor, as well. Conclusion: Both aging and comorbidities modify the outcomes of AP. Comorbidities seem to be decisive regarding mortality and severity, however, age is a strong predictor of the latter, as well. The middle-aged are the most likely to develop local complications, whereas those having severe comorbidities are vulnerable to developing systemic complications. Studies validating the implementation of CCI-based predictive scores are awaited.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk acute pancreatitis comorbidities mortality severity length of hospitalization complications prediction Charlson Comorbidity Index
Megjelenés:	Frontiers in Physiology. - 2019 (2019). -
További szerzők:	Gede Noémi Pécsi Dániel Izbéki Ferenc Papp Mária (1975-) (belgyógyász, gasztroenterológus) Kovács György (1982-) (belgyógyász, gasztroenterológus) Fehér Eszter Dobszai Dalma Kui Balázs Márta Katalin Kónya Klára Szabó Imre Török Imola Gajdán László Takács Tamás (Szeged) Sarlós Patrícia Gódi Szilárd Varga Márta Hamvas József Vincze Áron Szentesi Andrea Párniczky Andrea (gyermekgyógyász) Hegyi Péter Jenő (belgyógyász)
Pályázati támogatás:	KH125678 OTKA K116634 OTKA K120335 OTKA GINOP-2.3.2-15-2016-00048 GINOP EFOP-3.6.2-16-2017-00006 EFOP
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001-es BibID:	BIBFORM082672
035-os BibID:	(cikkazonosító)1202 (WoS)000487293600001 (Scopus)85072974153
Első szerző:	Szentesi Andrea
Cím:	Multiple Hits in Acute Pancreatitis : Components of Metabolic Syndrome Synergize Each Other's Deteriorating Effects / Andrea Szentesi, Andrea Párniczky, Áron Vincze, Judit Bajor, Szilárd Gódi, Patricia Sarlós, Noémi Gede, Ferenc Izbéki, Adrienn Halász, Katalin Márta, Dalma Dobszai, Imola Török, Hunor Farkas, Mária Papp, Márta Varga, József Hamvas, János Novák, Artautas Mickevicius, Elena Ramirez Maldonado, Ville Sallinen, Dóra Illés, Balázs Kui, Bálint Erőss, László Czakó, Tamás Takács, Péter Jr. Hegyi, Hungarian Pancreatic Study Group
Dátum:	2019
ISSN:	1664-042X
Megjegyzések:	Introduction: The incidence of acute pancreatitis (AP) and the prevalence of metabolic syndrome (MetS) are growing worldwide. Several studies have confirmed that obesity (OB), hyperlipidemia (HL), or diabetes mellitus (DM) can increase severity, mortality, and complications in AP. However, there is no comprehensive information on the independent or joint effect of MetS components on the outcome of AP. Our aims were (1) to understand whether the components of MetS have an independent effect on the outcome of AP and (2) to examine the joint effect of their combinations. Methods: From 2012 to 2017, 1435 AP cases from 28 centers were included in the prospective AP Registry. Patient groups were formed retrospectively based on the presence of OB, HL, DM, and hypertension (HT). The primary endpoints were mortality, severity, complications of AP, and length of hospital stay. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated. Results: 1257 patients (55.7 ? 17.0 years) were included in the analysis. The presence of OB was an independent predictive factor for renal failure [OR: 2.98 (CI: 1.33?6.66)] and obese patients spent a longer time in hospital compared to non-obese patients (12.1 vs. 10.4 days, p = 0.008). HT increased the risk of severe AP [OR: 3.41 (CI: 1.39?8.37)], renal failure [OR: 7.46 (CI: 1.61?34.49)], and the length of hospitalization (11.8 vs. 10.5 days, p = 0.020). HL increased the risk of local complications [OR: 1.51 (CI: 1.10?2.07)], renal failure [OR: 6.4 (CI: 1.93?21.17)], and the incidence of newly diagnosed DM [OR: 2.55 (CI: 1.26?5.19)]. No relation was found between the presence of DM and the outcome of AP. 906 cases (mean age ? SD: 56.9 ? 16.7 years) had data on all four components of MetS available. The presence of two, three, or four MetS factors increased the incidence of an unfavorable outcome compared to patients with no MetS factors. Conclusion: OB, HT, and HL are independent risk factors for a number of complications. HT is an independent risk factor for severity as well. Components of MetS strongly synergize each other's detrimental effect. It is important to search for and follow up on the components of MetS in AP.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk acute pancreatitis metabolic syndrome obesity diabetes mellitus hypertension hyperlipidemia severity mortality
Megjelenés:	Frontiers in Physiology. - 10 (2019), p. 1-13. -
További szerzők:	Párniczky Andrea (gyermekgyógyász) Vincze Áron Bajor Judit Gódi Szilárd Sarlós Patrícia Gede Noémi Izbéki Ferenc Halász Adrienn Márta Katalin Dobszai Dalma Török Imola Farkas Hunor Papp Mária (1975-) (belgyógyász, gasztroenterológus) Varga Márta Hamvas József Novák János Mickevicius, Artautas Maldonado, Elena Ramirez Sallinen, Ville Illés Dóra Kui Balázs Erőss Bálint Czakó László Takács Tamás (Szeged) Hegyi Péter Jr. (belgyógyász) Hungarian Pancreatic Study Group
Pályázati támogatás:	KH125678 Egyéb K116634 Egyéb K120335 Egyéb K128222 Egyéb GINOP 2.3.2-15-2016-00048 GINOP EFOP-3.6.2-16-2017-00006 EFOP LP2014-10/2014 Egyéb
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