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. 2022 Oct 1;50(10):1513-1521.
doi: 10.1097/CCM.0000000000005629. Epub 2022 Jul 25.

Trends in Early and Late Mortality in Patients With Severe Acute Pancreatitis Admitted to ICUs: A Nationwide Cohort Study

Daniel R J Wolbrink  1 , Marcel C G van de Poll  2   3   4 , Fabian Termorshuizen  5   6   7 , Nicolette F de Keizer  5   6   7 , Iwan C C van der Horst  2   8 , Ronny Schnabel  2 , Cees H C Dejong  4 , Hjalmar C van Santvoort  9   10 , Marc G Besselink  11 , Harry van Goor  1 , Stefan A W Bouwense  4 , Bas C T van Bussel  2   7   12 ; Dutch Pancreatitis Study Group and the Dutch National Intensive Care Evaluation (NICE) Collaborators
Affiliations

Trends in Early and Late Mortality in Patients With Severe Acute Pancreatitis Admitted to ICUs: A Nationwide Cohort Study

Daniel R J Wolbrink et al. Crit Care Med. .

Abstract

Objectives: To investigate national mortality trends over a 12-year period for patients with severe acute pancreatitis (SAP) admitted to Dutch ICUs. Additionally, an assessment of outcome in SAP was undertaken to differentiate between early (< 14 d of ICU admission) and late (> 14 d of ICU admission) mortality.

Design: Data from the Dutch National Intensive Care Evaluation and health insurance companies' databases were extracted. Outcomes included 14-day, ICU, hospital, and 1-year mortality. Mortality before and after 2010 was compared using mixed logistic regression and mixed Cox proportional-hazards models. Sensitivity analyses, excluding early mortality, were performed to assess trends in late mortality.

Setting: Not applicable.

Patients: Consecutive adult patients with SAP admitted to all 81 Dutch ICUs between 2007 and 2018.

Interventions: Not applicable.

Measurements and main results: Among 4,160 patients treated in 81 ICUs, 14-day mortality was 17%, ICU mortality 17%, hospital mortality 23%, and 1-year mortality 33%. After 2010 in-hospital mortality adjusted for age, sex, modified Marshall, and Acute Physiology and Chronic Health Evaluation III scores were lower (odds ratio [OR], 0.76; 95% CI, 0.61-0.94) than before 2010. There was no change in ICU and 1-year mortality. Sensitivity analyses excluding patients with early mortality demonstrated a decreased ICU mortality (OR, 0.45; 95% CI, 0.32-0.64), decreased in-hospital (OR, 0.48; 95% CI, 0.36-0.63), and decreased 1-year mortality (hazard ratio, 0.81; 95% CI, 0.68-0.96) after 2010 compared with 2007-2010.

Conclusions: Over the 12-year period examined, mortality in patients with SAP admitted to Dutch ICUs did not change, although after 2010 late mortality decreased. Novel therapies should focus on preventing early mortality in SAP.

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Conflict of interest statement

Drs. Termorshuizen’s and de Keizer’s institutions received funding from the National Intensive Care Evaluation Foundation. Dr. Termorshuizen’s institution received funding from the Rivierduinen Institute for Mental Health Care. Dr. de Keizer’s institution received funding from the Ministry of Health and Welfare. The remaining authors have disclosed that they do not have any potential conflicts of interest.

References

    1. Peery AF, Dellon ES, Lund J, et al.: Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology 2012; 143:1179–1187.e3
    1. Banks PA, Bollen TL, Dervenis C, et al.; Acute Pancreatitis Classification Working Group: Classification of acute pancreatitis–2012: Revision of the Atlanta classification and definitions by international consensus. Gut 2013; 62:102–111
    1. Bakker OJ, van Santvoort H, Besselink MG, et al.; Dutch Pancreatitis Study Group: Extrapancreatic necrosis without pancreatic parenchymal necrosis: A separate entity in necrotising pancreatitis? Gut 2013; 62:1475–1480
    1. Schepers NJ, Bakker OJ, Besselink MG, et al.; Dutch Pancreatitis Study Group: Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis. Gut 2019; 68:1044–1051
    1. Guidelines WGIAAP: IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology 2013; 13(4 Suppl 2):e1–e15

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