Factors Associated with Fluid Sequestration in Patients with Acute Pancreatitis: A Prospective Study in Tertiary Centre Hospital in Nepal
Background. Acute pancreatitis (AP) is associated with extensive fluid sequestration. The aim of this study was to determine association of fluid sequestration at 48 hours after hospital admission (FS48) in AP patients with demographics, clinical parameters, and outcomes of AP. Methods. A prospectiv...
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Wiley
2021-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/5579267 |
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| author | Raju Bhandari Krishna Sapkota Seema Subedi Som Kumar Shrestha Edward Sutanto Prabhat Jha Ramesh Singh Bhandari |
| author_facet | Raju Bhandari Krishna Sapkota Seema Subedi Som Kumar Shrestha Edward Sutanto Prabhat Jha Ramesh Singh Bhandari |
| author_sort | Raju Bhandari |
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| description | Background. Acute pancreatitis (AP) is associated with extensive fluid sequestration. The aim of this study was to determine association of fluid sequestration at 48 hours after hospital admission (FS48) in AP patients with demographics, clinical parameters, and outcomes of AP. Methods. A prospective observational study was carried out on all adult patients with AP admitted to Tribhuvan University Teaching Hospital, Nepal, from January to September 2017. FS48 was calculated as the difference between fluid input and output in the first 48 hours of admission. The Kruskal-Wallis test with post hoc Dunn’s test examined the difference in FS48 between mild AP, moderately severe AP, and severe AP. Linear regression analysis was used to evaluate association between FS48 with patients’ characteristics and outcomes of AP. Outcomes of AP assessed included pancreatic necrosis, persistent organ failure, length of stay, and in-hospital mortality. Results. Eighty patients (median age 44 years; 57% male) with a median FS48 of 1610 mL were evaluated. The median FS48 for mild AP, moderately severe AP, and severe AP were 1,180 mL, 2,380 mL, and 3,500 mL, respectively. There was a significant difference in pairwise comparisons between mild AP and moderately severe AP, along with mild AP and severe AP. Younger age, other etiology, and higher creatinine were independently associated with increased FS48. Increased FS48 was significantly associated with pancreatic necrosis, persistent organ failure, and in-hospital mortality. Conclusions. In our study population, younger age and higher creatinine were predictors of increased FS48. Increased FS48 was associated with poorer outcomes of AP. |
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| institution | Kabale University |
| issn | 1687-6121 1687-630X |
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| series | Gastroenterology Research and Practice |
| spelling | doaj-art-35d05bb63f5a4adebbfa697adcaf73242025-02-03T01:25:18ZengWileyGastroenterology Research and Practice1687-61211687-630X2021-01-01202110.1155/2021/55792675579267Factors Associated with Fluid Sequestration in Patients with Acute Pancreatitis: A Prospective Study in Tertiary Centre Hospital in NepalRaju Bhandari0Krishna Sapkota1Seema Subedi2Som Kumar Shrestha3Edward Sutanto4Prabhat Jha5Ramesh Singh Bhandari6Department of General and Gastrointestinal Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu, NepalPublic Health Officer, Health Coordination Division, Ministry of Health and Population, Government of Nepal, NepalGlobal Disease Epidemiology and Control, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USADepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UKDepartment of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, USADepartment of General and Gastrointestinal Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu, NepalDepartment of General and Gastrointestinal Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu, NepalBackground. Acute pancreatitis (AP) is associated with extensive fluid sequestration. The aim of this study was to determine association of fluid sequestration at 48 hours after hospital admission (FS48) in AP patients with demographics, clinical parameters, and outcomes of AP. Methods. A prospective observational study was carried out on all adult patients with AP admitted to Tribhuvan University Teaching Hospital, Nepal, from January to September 2017. FS48 was calculated as the difference between fluid input and output in the first 48 hours of admission. The Kruskal-Wallis test with post hoc Dunn’s test examined the difference in FS48 between mild AP, moderately severe AP, and severe AP. Linear regression analysis was used to evaluate association between FS48 with patients’ characteristics and outcomes of AP. Outcomes of AP assessed included pancreatic necrosis, persistent organ failure, length of stay, and in-hospital mortality. Results. Eighty patients (median age 44 years; 57% male) with a median FS48 of 1610 mL were evaluated. The median FS48 for mild AP, moderately severe AP, and severe AP were 1,180 mL, 2,380 mL, and 3,500 mL, respectively. There was a significant difference in pairwise comparisons between mild AP and moderately severe AP, along with mild AP and severe AP. Younger age, other etiology, and higher creatinine were independently associated with increased FS48. Increased FS48 was significantly associated with pancreatic necrosis, persistent organ failure, and in-hospital mortality. Conclusions. In our study population, younger age and higher creatinine were predictors of increased FS48. Increased FS48 was associated with poorer outcomes of AP.http://dx.doi.org/10.1155/2021/5579267 |
| spellingShingle | Raju Bhandari Krishna Sapkota Seema Subedi Som Kumar Shrestha Edward Sutanto Prabhat Jha Ramesh Singh Bhandari Factors Associated with Fluid Sequestration in Patients with Acute Pancreatitis: A Prospective Study in Tertiary Centre Hospital in Nepal Gastroenterology Research and Practice |
| title | Factors Associated with Fluid Sequestration in Patients with Acute Pancreatitis: A Prospective Study in Tertiary Centre Hospital in Nepal |
| title_full | Factors Associated with Fluid Sequestration in Patients with Acute Pancreatitis: A Prospective Study in Tertiary Centre Hospital in Nepal |
| title_fullStr | Factors Associated with Fluid Sequestration in Patients with Acute Pancreatitis: A Prospective Study in Tertiary Centre Hospital in Nepal |
| title_full_unstemmed | Factors Associated with Fluid Sequestration in Patients with Acute Pancreatitis: A Prospective Study in Tertiary Centre Hospital in Nepal |
| title_short | Factors Associated with Fluid Sequestration in Patients with Acute Pancreatitis: A Prospective Study in Tertiary Centre Hospital in Nepal |
| title_sort | factors associated with fluid sequestration in patients with acute pancreatitis a prospective study in tertiary centre hospital in nepal |
| url | http://dx.doi.org/10.1155/2021/5579267 |
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