Early encapsulation of peripancreatic fluid/necrosis collections on imaging (CECT) in acute pancreatitis : influential factors and clinical significance for prognosis
© 2024. The Author(s)..
BACKGROUND: To identify the factors influencing the early encapsulation of peripancreatic fluid/necrosis collections via contrast-enhanced computed tomography (CECT) and to determine the clinical significance of early encapsulation for determining the prognosis of acute pancreatitis (AP) patients.
METHODS: AP patients who underwent CECT between 4 and 10 days after disease onset were enrolled in this study. Early encapsulation was defined as a continuous enhancing wall around peripancreatic fluid/necrosis collections on CECT. Univariate and multivariate logistic regression analyses were performed to assess the associations between the variables and early encapsulation. Clinical outcomes were compared between the non-encapsulation and early encapsulation groups with 1:1 propensity score matching.
RESULTS: A total of 289 AP patients were enrolled. The intra-observer and inter-observer agreement were considered good (kappa statistics of 0.729 and 0.614, respectively) for identifying early encapsulation on CECT. The ratio of encapsulation increased with time, with a ratio of 12.5% on day 5 to 48.7% on day 9. Multivariate logistic regression analysis revealed that the longer time from onset to CECT examination (OR 1.55, 95% CI 1.23-1.97), high alanine aminotransferase level (OR 0.98, 95% CI 0.97-0.99), and high APACHE II score (OR 0.89, 95% CI 0.81-0.98) were found to be independent factors associated with delayed encapsulation. The incidence of persistent organ failure was significantly lower in the early encapsulation group after matching (22.4% vs 6.1%, p = 0.043). However, there was no difference in the incidence of infected pancreatic necrosis, surgical intervention, or in-hospital mortality.
CONCLUSIONS: AP patients without early encapsulation of peripancreatic fluid/necrosis collections have a greater risk of persistent organ failure. In addition to longer time, the high APACHE II score and elevated alanine aminotransferase level are factors associated with delayed encapsulation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
BMC gastroenterology - 24(2024), 1 vom: 29. Jan., Seite 53 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ning, Ning [VerfasserIn] |
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| Links: |
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| Themen: |
Acute pancreatitis |
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| Anmerkungen: |
Date Completed 31.01.2024 Date Revised 01.02.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/s12876-024-03145-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM367775751 |
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| 245 | 1 | 0 | |a Early encapsulation of peripancreatic fluid/necrosis collections on imaging (CECT) in acute pancreatitis |b influential factors and clinical significance for prognosis |
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| 520 | |a © 2024. The Author(s). | ||
| 520 | |a BACKGROUND: To identify the factors influencing the early encapsulation of peripancreatic fluid/necrosis collections via contrast-enhanced computed tomography (CECT) and to determine the clinical significance of early encapsulation for determining the prognosis of acute pancreatitis (AP) patients | ||
| 520 | |a METHODS: AP patients who underwent CECT between 4 and 10 days after disease onset were enrolled in this study. Early encapsulation was defined as a continuous enhancing wall around peripancreatic fluid/necrosis collections on CECT. Univariate and multivariate logistic regression analyses were performed to assess the associations between the variables and early encapsulation. Clinical outcomes were compared between the non-encapsulation and early encapsulation groups with 1:1 propensity score matching | ||
| 520 | |a RESULTS: A total of 289 AP patients were enrolled. The intra-observer and inter-observer agreement were considered good (kappa statistics of 0.729 and 0.614, respectively) for identifying early encapsulation on CECT. The ratio of encapsulation increased with time, with a ratio of 12.5% on day 5 to 48.7% on day 9. Multivariate logistic regression analysis revealed that the longer time from onset to CECT examination (OR 1.55, 95% CI 1.23-1.97), high alanine aminotransferase level (OR 0.98, 95% CI 0.97-0.99), and high APACHE II score (OR 0.89, 95% CI 0.81-0.98) were found to be independent factors associated with delayed encapsulation. The incidence of persistent organ failure was significantly lower in the early encapsulation group after matching (22.4% vs 6.1%, p = 0.043). However, there was no difference in the incidence of infected pancreatic necrosis, surgical intervention, or in-hospital mortality | ||
| 520 | |a CONCLUSIONS: AP patients without early encapsulation of peripancreatic fluid/necrosis collections have a greater risk of persistent organ failure. In addition to longer time, the high APACHE II score and elevated alanine aminotransferase level are factors associated with delayed encapsulation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute pancreatitis | |
| 650 | 4 | |a Contrast-enhanced computed tomography | |
| 650 | 4 | |a Infection | |
| 650 | 4 | |a Organ failure | |
| 650 | 4 | |a Risk factors | |
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| 700 | 1 | |a Sun, Wenwu |e verfasserin |4 aut | |
| 700 | 1 | |a Wen, Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Ni, Tongtian |e verfasserin |4 aut | |
| 700 | 1 | |a Sheng, Huiqiu |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Li |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Erzhen |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Bing |e verfasserin |4 aut | |
| 700 | 1 | |a Mao, Enqiang |e verfasserin |4 aut | |
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