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001-es BibID:	BIBFORM083103
Első szerző:	Koncz Balázs
Cím:	LIFEStyle, Prevention and Risk of Acute PaNcreatitis (LIFESPAN) : protocol of a multicentre and multinational observational case-control study / Koncz Balázs, Darvasi Erika, Erdősi Dalma, Szentesi Andrea, Márta Katalin, Erőss Bálint, Pécsi Dániel, Gyöngyi Zoltán, Girán János, Farkas Nelli, Papp Maria, Fehér Eszter, Vitális Zsuzsanna, Janka Tamás, Vincze Áron, Izbéki Ferenc, Dunás-Varga Veronika, Gajdán László, Török Imola, Károly Sándor, Antal Judit, Zádori Noémi, Lerch Markus M., Neoptolemos John, Sahin-Toth Miklos, Petersen Ole H., Hegyi Péter
Dátum:	2020
ISSN:	2044-6055 2044-6055
Megjegyzések:	AbstrACt Introduction Acute pancreatitis (AP) is a life- threatening inflammatory disease of the exocrine pancreas which needs acute hospitalisation. Despite its importance, we have significant lack of knowledge whether the lifestyle factors elevate or decrease the risk of AP or influence the disease outcome. So far, no synthetising study has been carried out examining associations between socioeconomic factors, dietary habits, physical activity, chronic stress, sleep quality and AP. Accordingly, LIFESPAN identifies risk factors of acute pancreatitis and helps to prepare preventive recommendations for lifestyle elements. Methods and analysis LIFESPAN is an observational, multicentre international case?control study. Participating subjects will create case and control groups. The study protocol was designed according to the SPIRIT guideline. Patients in the case group (n=1700) have suffered from AP (alcohol- induced, n=500; biliary, n=500; hypertriglyceridemiainduced, n=200; other, n=500); the control group subjects have no AP in their medical history. Our study will have three major control groups (n=2200): hospital- based (n=500), population- based (n=500) and aetiology- based (alcohol, n=500; biliary, n=500 and hypertriglyceridemia, n=200). All of them will be matched to the case group individually by gender, age and location of residence. Aggregately, 3900 subjects will be enrolled into the study. The study participants will complete a complex questionnaire with the help of a clinical research administrator/study nurse. Analysis methods include analysis of the continuous and categorical values. Ethics and dissemination The study has obtained the relevant ethical approval (54175-2/2018/EKU) and also internationally registered (ISRCTN25940508). After obtaining the final conclusions, we will publish the data to the medical community and will also disseminate our results via open access. trial registration number ISRCTN25940508; Pre- results.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban acute pancreatitis lifestyle prevention
Megjelenés:	BMJ Open. - 10 : 1 (2020), p. 1-9. -
További szerzők:	Darvasi Erika Erdősi Dalma Szentesi Andrea Márta Katalin Erőss Bálint Pécsi Dániel Gyöngyi Zoltán Girán János Farkas Nelli Papp Mária (1975-) (belgyógyász, gasztroenterológus) Fehér Eszter Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Janka Tamás Vincze Áron Izbéki Ferenc Dunás-Varga Veronika Gajdán László Török Imola Károly Sándor Antal Judit Zádori Noémi Lerch, Markus M. Neoptoleomos, Johan P. Sahin-Tóth Miklós Petersen, Ole H. Hegyi Péter Jenő (belgyógyász)
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001-es BibID:	BIBFORM101294
035-os BibID:	(cikkazonosító)e842 (wos)000804849400001
Első szerző:	Kui Balázs
Cím:	EASY-APP : an artificial intelligence model and application for early and easy prediction of severity in acute pancreatitis / Kui Balázs, Pintér József, Molontay Roland, Nagy Marcell, Farkas Nelli, Gede Noémi, Vincze Áron, Bajor Judit, Gódi Szilárd, Czimmer József, Szabó Imre, Illés Anita, Sarlós Patrícia, Hágendorn Roland, Pár Gabriella, Papp Mária, Vitális Zsuzsanna, Kovács György, Fehér Eszter, Földi Ildikó, Izbéki Ferenc, Gajdán László, Fejes Roland, Németh Balázs Csaba, Török Imola, Farkas Hunor, Artautas Mickevicius, Ville Sallinen, Shamil Galeev, Elena Ramirez Maldonado, Párniczky Andrea, Erőss Bálint, Hegyi Péter Jenő, Márta Katalin, Váncsa Szilárd, Sutton Robert, Enrique de-Madaria, Elizabeth Pando, Piero Alberti, Maria José Gómez-Jurado, Alina Tantau, Szentesi Andrea, Hegyi Péter, Hungarian Pancreatic Study Group
Dátum:	2022
ISSN:	2001-1326
Megjegyzések:	Background: Acute pancreatitis (AP) is a potentially severe or even fatal inflammation of the pancreas. Early identification of patients, who are at high risk for developing a severe course of the disease is crucial for preventing organ failure and death. Most of the former predictive scores require many parameters or at least 24 hours to predict the severity, so the early therapeutic window is missing. Methods: The early achievable severity index (EASY) is a registered multicentre, multinational, prospective, observational study (ISRCTN10525246). Clinical parameters were collected from 15 countries and 28 medical centres via eCRF. The predictions were made using machine learning models including Decision Tree, Random Forest, Logistic Regression, SVM, CatBoost, and XGBoost. For the modeling, we used the scikit-learn, xgboost, and catboost Python packages. We have evaluated our models using 4-fold cross-validation and the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), and accuracy metrics have been calculated on the union of the test sets of the cross-validation. The most important factors and their contribution to the prediction were identified using a modern tool of explainable artificial intelligence, called SHapley Additive exPlanations (SHAP). Using the XGBoost machine learning algorithm for prediction, the SHAP values for the explanation, and the bootstrapping method for the estimation of confidence we have developed a web application in the Streamlit Python-based framework. Results: The prediction model is based on the international cohort of 1184 patients and a validation cohort of 3543 patients. The best performing model has been an XGBoost classifier with an average AUC score of 0.81 and accuracy of 89.1% and the model is improving with experience. The six most influential features are the respiratory rate, body temperature, abdominal muscular reflex, gender, age, and glucose level. Finally, a free and easy-to-use web application was developed (http://easy-app.org/). Conclusions: The EASY prediction score is a practical tool for identifying patients at high risk for severe acute pancreatitis within hours of hospital admission. The easy-to-use web application is available for clinicians and contributes to the improvement of the model.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk severity prediction acute pancreatitis artificial intelligence
Megjelenés:	Clinical and Translational Medicine. - 12 : 6 (2022), p. 1-13. -
További szerzők:	Pintér József (1930-) (urológus) Molontay Roland Nagy Marcell Farkas Nelli Gede Noémi Vincze Áron Bajor Judit Gódi Szilárd Czimmer József Szabó Imre Illés Anita Sarlós Patrícia Hágendorn Roland Pár Gabriella Papp Mária (1975-) (belgyógyász, gasztroenterológus) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Kovács György (1982-) (belgyógyász, gasztroenterológus) Fehér Eszter Földi Ildikó (1981-) (orvos) Izbéki Ferenc Gajdán László Fejes Roland Németh Balázs Csaba Török Imola Farkas Hunor Mickevicius, Artautas Sallinen, Ville Galeev, Shamil Ramírez-Maldonado, Elena Párniczky Andrea (gyermekgyógyász) Erőss Bálint Hegyi Péter Jenő (belgyógyász) Márta Katalin Váncsa Szilárd Sutton, Robert de-Madaria, Enrique Pando, Elizabeth Alberti, Piero Gómez-Jurado, Maria José Tantau, Alina Szentesi Andrea Hegyi Péter (pszichológus) Hungarian Pancreatic Study Group
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001-es BibID:	BIBFORM095975
Első szerző:	Nagy Anikó
Cím:	Glucose levels show independent and dose-dependent association with worsening acute pancreatitis outcomes: Post-hoc analysis of a prospective, international cohort of 2250 acute pancreatitis cases / Aniko Nagy, Mark Félix Juhász, Anikó Görbe, Alex Váradi, Ferenc Izbéki, Áron Vincze, Patrícia Sarlós, József Czimmer, Zoltán Szepes, Tamás Takács, Mária Papp, Eszter Fehér, József Hamvas, Klaudia Kárász, Imola Török, Davor Stimac, Goran Poropat, Ali Tüzün Ince, Bálint Erőss, Katalin Márta, Dániel Pécsi, Dóra Illés, Szilárd Váncsa, Mária Földi, Nándor Faluhelyi, Orsolya Farkas, Tamás Nagy, Péter Kanizsai, Zsolt Márton, Andrea Szentesi, Péter Hegyi, Andrea Párniczky
Dátum:	2021
ISSN:	1424-3903
Megjegyzések:	Background: Metabolic risk factors, such as obesity, hypertension, and hyperlipidemia are independent risk factors for the development of various complications in acute pancreatitis (AP). Hypertriglyceridemia dose-dependently elicits pancreatotoxicity and worsens the outcomes of AP. The role of hyperglycemia, as a toxic metabolic factor in the clinical course of AP, has not been examined yet. Methods: We analyzed a prospective, international cohort of 2250 AP patients, examining associations between (1) glycosylated hemoglobin (HbA1c), (2) on-admission glucose, (3) peak in-hospital glucose and clinically important outcomes (mortality, severity, complications, length of hospitalization (LOH), maximal C-reactive protein (CRP)). We conducted a binary logistic regression accounting for age, gender, etiology, diabetes, and our examined variables. Receiver Operating Characteristic Curve (ROC) was applied to detect the diagnostic accuracy of the three variables. Results: Both on-admission and peak serum glucose are independently associated with AP severity and mortality, accounting for age, gender, known diabetes and AP etiology. They show a dose-dependen association with severity (p < 0.001 in both), mortality (p < 0.001), LOH (p < 0.001), maximal CRP (p < 0.001), systemic (p < 0.001) and local complications (p < 0.001). Patients with peak glucose >7 mmol/l had a 15 times higher odds for severe AP and a five times higher odds for mortality. We found a trend of increasing HbA1c with increasing LOH (p < 0.001), severity and local complications. Conclusions: On-admission and peak in-hospital glucose are independently and dose-dependently associated with increasing AP severity and mortality. In-hospital laboratory control of glucose and adequate treatment of hyperglycemia are crucial in the management of AP. ? 2021 Published by Elsevier B.V. on behalf of IAP and EPC.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Pancreatology. - 21 : 7 (2021), p. 1237-1246. -
További szerzők:	Juhász Márk Félix Görbe Anikó Váradi Alex (1991-) (biológus) Izbéki Ferenc Vincze Áron Sarlós Patrícia Czimmer József Szepes Zoltán Takács Tamás (Szeged) Papp Mária (1975-) (belgyógyász, gasztroenterológus) Fehér Eszter Hamvas József Kárász Klaudia Török Imola Štimac, Davor Poropat, Goran Ince, Ali Tüzün Erőss Bálint Márta Katalin Pécsi Dániel Illés Dóra Váncsa Szilárd Földi Mária Faluhelyi Nándor Farkas Orsolya Nagy Tamás Kanizsai Péter Márton Zsolt Szentesi Andrea Hegyi Péter Jenő (belgyógyász) Párniczky Andrea (gyermekgyógyász)
Pályázati támogatás:	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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