TY - JOUR
T1 - The Prognosis of Severe Acute Pancreatitis Varies According to the Segment Presenting with Low Enhanced Pancreatic Parenchyma on Early Contrast-Enhanced Computed Tomography
T2 - A Multicenter Cohort Study
AU - Kitamura, Katsuya
AU - Horibe, Masayasu
AU - Sanui, Masamitsu
AU - Sasaki, Mitsuhito
AU - Yamamiya, Akira
AU - Ishii, Yu
AU - Yoshida, Hitoshi
AU - Sawano, Hirotaka
AU - Goto, Takashi
AU - Ikeura, Tsukasa
AU - Hamada, Tsuyoshi
AU - Oda, Takuya
AU - Yasuda, Hideto
AU - Ogura, Yuki
AU - Miyazaki, Dai
AU - Hirose, Kaoru
AU - Chiba, Nobutaka
AU - Ozaki, Tetsu
AU - Yamashita, Takahiro
AU - Koinuma, Toshitaka
AU - Oshima, Taku
AU - Yamamoto, Tomonori
AU - Hirota, Morihisa
AU - Azumi, Yoshinori
AU - Nagata, Keiji
AU - Saito, Nobuyuki
AU - Sato, Mizuki
AU - Miyamoto, Kyohei
AU - Iwasaki, Eisuke
AU - Kanai, Takanori
AU - Mayumi, Toshihiko
N1 - Publisher Copyright:
© 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Objective The aim of this study was to investigate the outcomes of severe acute pancreatitis (SAP) according to the segment presenting with low enhanced pancreatic parenchyma (LEPP) on early contrast-enhanced computed tomography. Methods This was a post hoc analysis of a multicenter, retrospective study conducted at 44 institutions in Japan. Patients diagnosed as having SAP according to the Japanese Severity Score between January 2009 and December 2013 were included. We compared the effect of LEPP in each segment on mortality. Results A total of 1097 patients were assessed. The numbers of patients with LEPP in the pancreatic head (Ph), body (Pb), or tail (Pt) were 272, 273, and 204 (with some overlaps), respectively. In multivariate analysis, LEPP in Ph and Pt was significantly related to mortality (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.11-3.40 [P < 0.05], for LEPP in Ph; OR, 2.44; 95% CI, 1.27-4.67 [P < 0.05], for LEPP in Pt), but LEPP in Pb was unrelated to mortality (OR, 0.70; 95% CI, 0.35-1.37; P = 0.30). Conclusions Presence of LEPP in Ph and Pt on early contrast-enhanced computed tomography was independently associated with increased mortality in SAP. These patients require close observation to ensure timely and adequate intervention.
AB - Objective The aim of this study was to investigate the outcomes of severe acute pancreatitis (SAP) according to the segment presenting with low enhanced pancreatic parenchyma (LEPP) on early contrast-enhanced computed tomography. Methods This was a post hoc analysis of a multicenter, retrospective study conducted at 44 institutions in Japan. Patients diagnosed as having SAP according to the Japanese Severity Score between January 2009 and December 2013 were included. We compared the effect of LEPP in each segment on mortality. Results A total of 1097 patients were assessed. The numbers of patients with LEPP in the pancreatic head (Ph), body (Pb), or tail (Pt) were 272, 273, and 204 (with some overlaps), respectively. In multivariate analysis, LEPP in Ph and Pt was significantly related to mortality (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.11-3.40 [P < 0.05], for LEPP in Ph; OR, 2.44; 95% CI, 1.27-4.67 [P < 0.05], for LEPP in Pt), but LEPP in Pb was unrelated to mortality (OR, 0.70; 95% CI, 0.35-1.37; P = 0.30). Conclusions Presence of LEPP in Ph and Pt on early contrast-enhanced computed tomography was independently associated with increased mortality in SAP. These patients require close observation to ensure timely and adequate intervention.
KW - contrast-enhanced computed tomography
KW - low enhanced pancreatic parenchyma
KW - mortality
KW - pancreatic head and tail
KW - severe acute pancreatitis
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U2 - 10.1097/MPA.0000000000000851
DO - 10.1097/MPA.0000000000000851
M3 - Article
C2 - 28697125
AN - SCOPUS:85025636790
SN - 0885-3177
VL - 46
SP - 867
EP - 873
JO - Pancreas
JF - Pancreas
IS - 7
ER -
