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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
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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
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001-es BibID:BIBFORM094178
035-os BibID:(WOS)000727779500019 (Scopus)85106978919
Első szerző:Szakó Lajos
Cím:Early occurrence of pseudocysts in acute pancreatitis - A multicenter international cohort analysis of 2275 cases / Lajos Szakó, Noémi Gede, Alex Váradi, Benedek Tinusz, Nóra Vörhendi, Dóra Mosztbacher, Áron Vincze, Tamás Takács, László Czakó, Ferenc Izbéki, László Gajdán, Veronika Dunás-Varga, József Hamvas, Mária Papp, Krisztina Eszter Fehér, Márta Varga, Artautas Mickevicius, Imola Török, Klementina Ocskay, Márk Félix Juhász, Szilárd Váncsa, Nándor Faluhelyi, Orsolya Farkas, Attila Miseta, András Vereczkei, Alexandra Mikó, Péter Jenő Hegyi, Andrea Szentesi, Andrea Párniczky, Bálint Erőss, Péter Hegyi
Dátum:2021
ISSN:1424-3903
Megjegyzések:BACKGROUND Pseudocysts being the most frequent local complications of acute pancreatitis (AP) have substantial effect on the disease course, hospitalization and quality of life of the patient. Our study aimed to understand the effects of pre existing (OLD-P) and newly developed (NEW-P) pseudocysts on AP. METHODS Data were extracted from the Acute Pancreatitis Registry organized by the Hungarian Pancreatic Study Group (HPSG). 2275 of 2461 patients had uploaded information concerning pancreatic morphology assessed by imaging technique. Patients were divided into "no pseudocyst" (NO-P) group, "old pseudocyst" (OLD-P) group, or "newly developed pseudocyst" (NEW-P) groups. RESULTS The median time of new pseudocyst development was nine days from hospital admission and eleven days from the beginning of the abdominal pain. More NEW-P cases were severe (15.9% vs 4.7% in the NO-P group p<0.001), with longer length of hospitalization (LoH) (median: 14 days versus 8 days, p<0.001), and were associated with several changed laboratory parameters. OLD-P was associated with male gender (72.2% vs. 56.1%, p=0.0014), alcoholic etiology (35.2% vs. 19.8% in the NO-P group), longer hospitalization (median: 10 days, p<0.001), a previous episode of AP (p<0.001), pre-existing diagnosis of chronic pancreatitis (CP) (p<0.001), current smoking (p<0.001), and increased alcohol consumption (unit/week) (p=0.014). CONCLUSION Most of the new pseudocysts develop within two weeks. Newly developing pseudocysts are associated with a more severe disease course and increased length of hospitalization. Pre-existing pseudocysts are associated with higher alcohol consumption and smoking. Because CP is more frequently associated with a pre-existing pseudocyst, these patients need closer attention after AP.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Pancreatology. - 21 : 6 (2021), p. 1161-1172. -
További szerzők:Gede Noémi Váradi Alex (1991-) (biológus) Tinusz Benedek Vörhendi Nóra Mosztbacher Dóra Vincze Áron Takács Tamás (Szeged) Czakó László Izbéki Ferenc Gajdán László Dunás-Varga Veronika Hamvas József Papp Mária (1975-) (belgyógyász, gasztroenterológus) Fehér Krisztina Eszter Varga Márta Mickevicius, Artautas Török Imola Ocskay Klementina Juhász Márk Félix Váncsa Szilárd Faluhelyi Nándor Farkas Orsolya Miseta Attila Vereczkei András Mikó Alexandra Hegyi Péter Jr. (belgyógyász) Szentesi Andrea Párniczky Andrea (gyermekgyógyász) Erőss Bálint Hegyi Péter Jenő (belgyógyász)
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