Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study
Post-hoc analysis
Abdominal Compartment Syndrome
DOI:
10.1007/s13304-023-01488-6
Publication Date:
2023-03-11T17:38:15Z
AUTHORS (580)
ABSTRACT
The identification of high-risk patients in the early stages infected pancreatic necrosis (IPN) is critical, because it could help clinicians to adopt more effective management strategies. We conducted a post hoc analysis MANCTRA-1 international study assess association between clinical risk factors and mortality among adult with IPN. Univariable multivariable logistic regression models were used identify prognostic mortality. identified 247 consecutive IPN hospitalised January 2019 December 2020. History uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA 0.005; 1.359-5.879; 2.828), renal failure 0.022; 1.138-5.442; 2.489), haemodynamic 0.018; 1.184-5.978; 2.661), as independent predictors patients. Cholangitis 0.003; 1.598-9.930; 3.983), abdominal compartment syndrome 1.090-6.967; 2.735), gastrointestinal/intra-abdominal bleeding 0.009; 1.286-5.712; 2.710) independently associated Upfront open surgical necrosectomy was strongly < 0.001; 1.912-7.442; 3.772), whereas endoscopic drainage 0.138-0.834; 0.339) enteral nutrition 0.143-0.716; 0.320) found protective factors. Organ failure, acute cholangitis, upfront most significant Our confirmed that, even subgroup particularly ill such those IPN, surgery should be avoided much possible. Study protocol registered ClinicalTrials.Gov (I.D. Number NCT04747990).
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