Table 5.
Clinical outcomes: studies in patients with MSAP or SAP
| Author, year; country | Study design; setting (data period) | SIRS (%) | SSOF or MSOF (%) | TOF or POF (%) | Admission to CC (%) | IPN (%) | Surgery due to PN (%) | Pancreatic pseudocysts (%) | Other long-term outcomes of surviving patients (%) | Mortality (%) |
| USA studies: MSAP | ||||||||||
| Koutroumpakis et al, 2017,19 Koutroumpakis et al, 201420; USA | Prospective cohort; hospital 2003 to 2014 |
SIRS on admission: 48% SIRS at 48 hours: 41% |
NR | TOF: 100% | 23% | 9% | NR | NR | NR | 0% |
| Kwong et al, 201621; USA | Retrospective cohort; secondary care November 2010 to December 2013 |
Day 1/Day 2 Score 1: 23/29% Score 2: 29/26% Score 3: 23% Score 4: 13/6% |
26.1% | TOF: 26.1% | 23% | NR | NR | NR | NR | NR |
| Talukdar et al, 201224; USA | Prospective cohort study; three hospitals June 2004 and August 2005 |
NR | NR | NR | 15% | NR | NR | NR | NR | 0% |
| USA studies: SAP | ||||||||||
| Bhat et al, 200718; USA | Prospective cohort; hospital June 2003 and January 2005 |
NR | SSOF: 31.6% (6/19) MSOF: 47.4% (9/19) |
NR | NR | PN: 21.1% | NR | NR | NR | 32% |
| Koutroumpakis et al, 2017,19 Koutroumpakis et al, 201420; USA | Prospective cohort; hospital 2003 to 2014 |
SIRS on admission: 65% SIRS at 48 hours: 77% |
SSOF: 40% MSOF: 60% |
100% | 93% | IPN: 32% PN: 68% |
NR | NR | NR | 21% |
| Mutch et al, 201123; USA | Retrospective cohort; seven hospitals (2008) | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Soran et al, 200022; USA | Retrospective cohort; secondary care 1992–1996 | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Talukdar et al, 201224; USA | Prospective cohort study; three hospitals June 2004 and August 2005 |
NR | SSOF: 47% MSOF: 53% Renal failure: 80% Respiratory failure: 67% Circulatory failure: 13% |
POF at presentation: 7% POF during hospital stay: 93% |
80% | NR | NR | NR | NR | 40% |
| EU-5 studies: MSAP | ||||||||||
| Pintado et al, 201636; Spain | Prospective cohort; 14-bed medical and surgical ICU 2010–2014 | NR | MOF at ICU admission: 0% MOF during ICU stay: 8.3% |
NR | NR | 10% | 16.7% | 0% | NR | 0% |
| EU-5 studies: SAP | ||||||||||
| Castoldi et al, 201332; Italy | Retrospective cohort; 35 hospitals (NR) | NR | NR | NR | NR | NR | NR | NR | Relapse to mild AP cases: 13.7% Relapse to severe AP: 8.2%: Recovery time: mean 53.4 (SD 41.1) days Diabetes: 4.1% |
Long-term (follow-up mean 49 (SD 10.7) months: 12.3% |
| Cinquepalmi et al, 200633; Italy | Retrospective cohort; hospital 1990–2005 | NR | NR | NR | NR | 100% (selection criterion for the study) | 100% (selection criterion for the study) | NR | NR | 22% |
| De Rai et al, 201034; Italy | Prospective cohort; 56 centres July 2002 and December 2011 |
NR | NR | NR | NR | 4.8% | 4.8% | NR | NR | 19.16% |
| Gomercic et al, 201635; France | Prospective cohort; hospital 2010–2012 | NR |
MOF: 4.2% |
NR |
|
NR | NR | NR | NR | NR |
| Gonzelez et al, 201125; UK | Retrospective study of prospective data; tertiary referral centre January 2008 and December 2009 |
NR | NR | NR | NR | 40% | NR | NR | NR | 5% |
| Hall et al, 201326; UK | Retrospective cohort; tertiary referral centre 2003–2011 | NR | NR | NR | NR | NR | NR | NR | NR | 17.8% |
| Harrison et al, 200727; UK | Retrospective cohort; general critical care units | NR | Emergency surgery: 10.5% Elective surgery: 5.3% |
NR | NR | CC unit mortality: 30.6% Ultimate hospital mortality: 41.9% Primary reason for admission: AP: 42.5% Infective pancreatitis: 48% Non-surgical: 44.3% |
||||
| Heiss et al, 201129; Germany | Retrospective cohort; tertiary referral single-centre 1992–2004 | NR | NR | NR | 81% | Necrosis of the pancreatic head: 68% parts of the pancreas that exhibited areas of necrosis: 0 parts: 9% one part: 29% two parts: 23% All three parts: 40% |
Surgical and percutaneous necrosectomy: 25% and 22.5% | NR | Extrapancreatic complications: 94% | Overall: 34% Among those with multiple organ dysfunction: 89% Among those with all 3 areas of necrosis: 38% Among those with the presence of distal fluid collections: 46% Absence of distal fluid collections: 42% |
| Patel, 201528; UK | Retrospective cohort; hospital 2007–2010 | NR | NR | NR | NR | 37% | ||||
| Pintado et al, 201636; Spain | Prospective cohort; 14-bed medical and surgical ICU 2010–2014 | NR | MOF at ICU admission: 36.4% MOF during ICU stay: 86.4 |
POF: 100% | NR | 11.4% | NR | 2.3% | NR | 29.5% |
| Rasch et al, 201630; Germany | Retrospective cohort; seven tertiary referral centres and three secondary hospitals 2008–2014 | NR | NR | Persistent dysfunction: 21.8% | NR | 72.7% | 13.6% | NR | NR | 13.6% |
| Wittau et al, 201031; Germany | Retrospective cohort; tertiary care hospital 1992–1997; 2001–2006 | NR | MOF: Group 1: 36% Group 2: 25% |
NR | NR | Group 1: 40% Group 2: 69% |
NR | NR | NR | Group 1: 28% Group 2: 14% |
ACG criteria required the presence of at least two of the following three factors: (1) abdominal pain characteristic of AP; (2) serum amylase and/or lipase levels three or more times ULN; (3) CT findings characteristic of AP.
ACG, American College of Gastroenterology; AP, acute pancreatitis; CC, coronary care; EU-5, European Union-5; ICU, intensive care unit; IPN, infected pancreatic necrosis; MOF, multiple organ failure; MSAP, moderately severe acute pancreatitis; MSOF, multisystem organ failure; NR, not reported; PN, pancreatic necrosis; POF, partial organ failure; SAP, severe acute pancreatitis; SD, standard deviation; SIRS, systemic inflammatory response syndrome; SSOF, single system organ failure; TOF, total organ failure; UK, United Kingdom; ULN, upper limit of normal; USA, United States of America.