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. 2023 Dec 13;13(1):22109.
doi: 10.1038/s41598-023-48480-z.

Discharge protocol in acute pancreatitis: an international survey and cohort analysis

Rita Nagy  1   2   3 , Klementina Ocskay  3 , Zoltán Sipos  2 , Andrea Szentesi  2 , Áron Vincze  4 , László Czakó  5 , Ferenc Izbéki  6 , Natalia V Shirinskaya  7 , Vladimir L Poluektov  8 , Alexandr N Zolotov  9 , Yin Zhu  10 , Liang Xia  10 , Wenhua He  10 , Robert Sutton  11 , Peter Szatmary  11 , Rajarshi Mukherjee  11 , Isobel Saffron Burridge  12 , Emma Wauchope  12 , Elsa Francisco  13 , David Aparicio  13 , Bruno Pinto  13 , António Gomes  13 , Vitor Nunes  13 , Vasile Marcel Tantau  14 , Emanuela Denisa Sagau  14 , Alina Ioana Tantau  15 , Andra Iulia Suceveanu  16 , Cristina Tocia  16 , Andrei Dumitru  16 , Elizabeth Pando  17 , Piero Alberti  17 , Arturo Cirera  17 , Xavier Molero  18 , Hong Sik Lee  19 , Min Kyu Jung  19 , Eui Joo Kim  20 , Sanghyub Lee  21 , María Lourdes Ruiz Rebollo  22 , Reyes Busta Nistal  22 , Sandra Izquierdo Santervas  22 , Dusan Lesko  23 , Marek Soltes  23 , Jozef Radonak  23 , Hubert Zatorski  24 , Ewa Małecka-Panas  24 , Adam Fabisiak  24 , M Susak Yaroslav  25 , V Maksymenko Mykhailo  25 , A Tkachenko Olekcandr  26 , Giedrius Barauskas  27 , Vytautas Simanaitis  27 , Povilas Ignatavicius  26 , Mariana Jinga  27 , Vasile-Daniel Balaban  27 , Cristina Patoni  28 , Liang Gong  28 , Kai Song  28 , Yunlong Li  28 , T Cúrdia Gonçalves  29   30   31 , Marta Freitas  32 , Vítor Macedo  32   29   30 , Marlies Vornhuelz  33 , Sarah Klauss  33 , Georg Beyer  33 , Aydin Seref Koksal  34 , Mukaddes Tozlu  34 , Ahmet Tarik Eminler  34 , Nuria Torres Monclús  35 , Eva Pijoan Comas  35 , Juan Armando Rodriguez Oballe  35 , Łukasz Nawacki  36 , Stanisław Głuszek  36 , Alberto Rama-Fernández  37 , Marco Galego  37 , Daniel de la Iglesia  37 , Umut Emre Aykut  38 , Deniz Güney Duman  38 , Rahmi Aslan  38 , Adriana Gherbon  39 , Lihui Deng  40 , Wei Huang  40 , Qing Xia  40 , Goran Poropat  41 , Anja Radovan  41 , Luka Vranić  41 , Claudio Ricci  42   43 , Carlo Ingaldi  42   43 , Riccardo Casadei  42   43 , Ionut Negoi  44 , Cezar Ciubotaru  44 , Florin Mihail Iordache  44 , Gabriel Constantinescu  44 , Vasile Sandru  44 , Engin Altintas  45 , Hatice Rizaoglu Balci  45 , Júlio Constantino  46 , Débora Aveiro  46 , Jorge Pereira  46 , Suleyman Gunay  47 , Seda Misirlioglu Sucan  47 , Oleksiy Dronov  48 , Inna Kovalska  48 , Nikhil Bush  49 , Surinder Singh Rana  49 , Serge Chooklin  50 , Serhii Chuklin  50 , Ionut Adrian Saizu  51 , Cristian Gheorghe  28   51 , Philipp Göltl  52 , Michael Hirth  52 , Radu Bogdan Mateescu  28   53 , Geanina Papuc  53 , Georgi Angelov Minkov  54 , Emil Tihomirov Enchev  54 , Laura Mastrangelo  55 , Elio Jovine  55 , Weiwei Chen  56 , Quping Zhu  56 , Anita Gąsiorowska  57 , Natalia Fabisiak  57 , Mihailo Bezmarevic  58 , Andrey Litvin  59 , Martina Cattani Mottes  60 , Eun Kwang Choi  61 , Peter Bánovčin  62 , Lenka Nosáková  62 , Mila Dimitrova Kovacheva-Slavova  63 , Ali Kchaou  64 , Ahmed Tlili  65 , Marco V Marino  66 , Katarzyna Kusnierz  67 , Artautas Mickevicius  67 , Marcus Hollenbach  68 , Pavol Molcan  69 , Orestis Ioannidis  70 , Mark Valerievich Tokarev  71 , Ali Tüzün Ince  72 , Ivan Albertovich Semenenko  73 , Shamil Galeev  74 , Elena Ramírez-Maldonado  75 , Ville Sallinen  76 , Petr Pencik  77 , Judit Bajor  4 , Patricia Sarlós  4 , Roland Hágendorn  4 , Szilárd Gódi  4 , Imre Szabó  4 , József Czimmer  4 , Gabriella Pár  4 , Anita Illés  4 , Nándor Faluhelyi  78 , Péter Kanizsai  79 , Tamás Nagy  80 , Alexandra Mikó  2 , Balázs Németh  5 , József Hamvas  81 , Barnabás Bod  82 , Márta Varga  83 , Imola Török  84 , János Novák  85 , Árpád Patai  86 , János Sümegi  87 , Csaba Góg  88 , Mária Papp  89 , Bálint Erőss  2   90 , Szilárd Váncsa  2   90   91 , Brigitta Teutsch  2   91 , Katalin Márta  90 , Péter Jenő Hegyi  90 , Tamás Tornai  90 , Balázs Lázár  90 , Tamás Hussein  90 , Dorottya Tarján  90 , Mónika Lipp  90 , Beáta Kovács  90 , Orsolya Urbán  90 , Emese Fürst  90 , Edina Tari  90 , Ibolya Kocsis  91 , Pál Maurovich-Horvát  92 , Balázs Tihanyi  93 , Orsolya Eperjesi  90 , Zita Kormos  90 , Pál Ákos Deák  94 , Andrea Párniczky  1   2   3 , Péter Hegyi  95   96   97   98
Affiliations

Discharge protocol in acute pancreatitis: an international survey and cohort analysis

Rita Nagy et al. Sci Rep. .

Abstract

There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) p < 0.001), and a lower rate of readmission due to recurrent AP episodes (p = 0.005). There was no difference in median discharge CRP level among the international cohorts (p = 0.586). HPSG-protocol resulted in the shortest LOH (6 (5;9) days) and highest median CRP (35.40 (13.78; 68.40) mg/l). Safety was confirmed by the low rate of readmittance (n = 35; 5%). Discharge protocol is necessary in AP. The discharge protocol used in this study is the first clinically proven protocol. Developing and testifying further protocols are needed to better standardize patients' care.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Map of the participating countries in the survey and analysis. The map shows the number of patients provided for analysis in different shades of green. A darker shade indicates more patients included. Created by MapChart (https://mapchart.net/world.html).
Figure 2
Figure 2
General characteristics of the international cohorts. Comparison of the protocol and non-protocol international cohorts. In terms of age, distribution of severity and etiology, and overall mortality there is a significant difference among the subcohorts (p < 0.05).
Figure 3
Figure 3
General characteristics of the Hungarian cohorts. Comparison of the protocol and non-protocol Hungarian cohorts. In terms of age, distribution of severity and etiology there is a significant difference among the subcohorts (p < 0.05).
See this image and copyright information in PMC

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