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Timing and impact of infections in acute pancreatitis
British journal of surgery, 2009-03, Vol.96 (3), p.267-273
Besselink, M. G.
van Santvoort, H. C.
Boermeester, M. A.
Nieuwenhuijs, V. B.
van Goor, H.
Dejong, C. H. C.
Schaapherder, A. F.
Gooszen, H. G.
2009
Details
Autor(en) / Beteiligte
Besselink, M. G.
van Santvoort, H. C.
Boermeester, M. A.
Nieuwenhuijs, V. B.
van Goor, H.
Dejong, C. H. C.
Schaapherder, A. F.
Gooszen, H. G.
Titel
Timing and impact of infections in acute pancreatitis
Ist Teil von
British journal of surgery, 2009-03, Vol.96 (3), p.267-273
Ort / Verlag
Chichester, UK: John Wiley & Sons, Ltd
Erscheinungsjahr
2009
Link zum Volltext
Quelle
Wiley Online Library Journals Frontfile Complete
Beschreibungen/Notizen
Background: Although infected necrosis is an established cause of death in acute pancreatitis, the impact of bacteraemia and pneumonia is less certain. Methods: This was a cohort study of 731 patients with a primary episode of acute pancreatitis in 2004–2007, including 296 patients involved in a randomized controlled trial to investigate the value of probiotic treatment in severe pancreatitis. Time of onset of bacteraemia, pneumonia, infected pancreatic necrosis, persistent organ failure and death were recorded. Results: The initial infection in 173 patients was diagnosed a median of 8 (interquartile range 3–20) days after admission (infected necrosis, median day 26; bacteraemia/pneumonia, median day 7). Eighty per cent of 61 patients who died had an infection. In 154 patients with pancreatic parenchymal necrosis, bacteraemia was associated with increased risk of infected necrosis (65 versus 37·9 per cent; P = 0·002). In 98 patients with infected necrosis, bacteraemia was associated with higher mortality (40 versus 16 per cent; P = 0·014). In multivariable analysis, persistent organ failure (odds ratio (OR) 18·0), bacteraemia (OR 3·4) and age (OR 1·1) were associated with death. Conclusion: Infections occur early in acute pancreatitis, and have a significant impact on mortality, especially bacteraemia. Prophylactic strategies should focus on early intervention. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Infection occurs early
Sprache
Englisch
Identifikatoren
ISSN: 0007-1323
eISSN: 1365-2168
DOI: 10.1002/bjs.6447
Titel-ID: cdi_proquest_miscellaneous_66947886
Format
–
Schlagworte
Acute Disease
,
Adult
,
Aged
,
Anti-Bacterial Agents - therapeutic use
,
Bacteremia - mortality
,
Bacteremia - prevention & control
,
Biological and medical sciences
,
Enteral Nutrition - methods
,
Female
,
Gastroenterology. Liver. Pancreas. Abdomen
,
General aspects
,
Gram-Negative Bacterial Infections - mortality
,
Gram-Positive Bacterial Infections - mortality
,
Humans
,
Liver. Biliary tract. Portal circulation. Exocrine pancreas
,
Male
,
Medical sciences
,
Middle Aged
,
Mycoses - mortality
,
Other diseases. Semiology
,
Pancreatitis - microbiology
,
Pancreatitis - mortality
,
Pancreatitis, Acute Necrotizing - mortality
,
Pneumonia, Bacterial - mortality
,
Pneumonia, Bacterial - prevention & control
,
Prognosis
,
Time Factors
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