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International multidisciplinary survey on the initial management of acute pancreatitis: Perspective of point-of-care specialists focused on daily practice

Authors
Lluis, NuriaAsbun, HoracioBesselink, Marc G.Capurso, GabrieleGarg, Pramod KumarGelrud, AndresKhannoussi, WafaaLee, Hong SikLeppaniemi, AriLohr, Johannes-MatthiasMahapatra, Soumya JagannathMancilla, Carlavan Santvoort, Hjalmar C.Zapater, PedroLluis, Felixde Madaria, EnriqueRamia, Jose Manuel
Issue Date
Jun-2022
Publisher
Springer Verlag
Keywords
antibiotic prophylaxis; cholecystectomy timing; feeding and nutrition; fluid therapy; ursodeoxycholic acid
Citation
Journal of Hepato-Biliary-Pancreatic Sciences
Indexed
SCIE
SCOPUS
Journal Title
Journal of Hepato-Biliary-Pancreatic Sciences
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61164
DOI
10.1002/jhbp.1201
ISSN
1868-6974
Abstract
Background The initial management of patients with acute pancreatitis impacts both morbidity and mortality. Point-of-care decisions have been reported to differ from clinical guideline recommendations. Methods An online anonymous questionnaire was distributed through scientific associations and social media using REDCap. Multivariable logistic regression was used to identify the characteristics of participants associated with compliance with the recommendations. Results A total of 1054 participants from 94 countries completed the questionnaire; median age (IQR) was 39 (32–47) years; 30.7% were women. Among the participants, 37% opted for nonmoderate flow of i.v. fluid, 31% for fluid type other than Ringer’s lactate; 73.4% were in favor of nil per os to patients who could eat, 75.5% for other than enteral feeding to patients with oral intolerance; 15.5% used prophylactic antibiotic in patients with severe acute pancreatitis, 34.1% in necrotizing acute pancreatitis, and 27.4% in patients with systemic inflammatory response syndrome; 27.8% delayed cholecystectomy after biliary acute pancreatitis. Participants with publications in PubMed on acute pancreatitis showed better compliance (OR, 1.62; 95% CI: 1.15–2.32; P = .007) with recommendations of the clinical guidelines. Conclusions Feeding and nutrition require the greatest improvement efforts, but also the use of prophylactic antibiotics and timing of cholecystectomy should be improved.
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Lee, Hong Sik
안암병원 (Department of Gastroenterology and Hepatology, Anam Hospital)
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