The Prognosis of Severe Acute Pancreatitis Varies According to the Segment Presenting with Low Enhanced Pancreatic Parenchyma on Early Contrast-Enhanced Computed Tomography: A Multicenter Cohort Study

Katsuya Kitamura, Masayasu Horibe, Masamitsu Sanui, Mitsuhito Sasaki, Akira Yamamiya, Yu Ishii, Hitoshi Yoshida, Hirotaka Sawano, Takashi Goto, Tsukasa Ikeura, Tsuyoshi Hamada, Takuya Oda, Hideto Yasuda, Yuki Ogura, Dai Miyazaki, Kaoru Hirose, Nobutaka Chiba, Tetsu Ozaki, Takahiro Yamashita, Toshitaka KoinumaTaku Oshima, Tomonori Yamamoto, Morihisa Hirota, Yoshinori Azumi, Keiji Nagata, Nobuyuki Saito, Mizuki Sato, Kyohei Miyamoto, Eisuke Iwasaki, Takanori Kanai, Toshihiko Mayumi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective The aim of this study was to investigate the outcomes of severe acute pancreatitis (SAP) according to the segment presenting with low enhanced pancreatic parenchyma (LEPP) on early contrast-enhanced computed tomography. Methods This was a post hoc analysis of a multicenter, retrospective study conducted at 44 institutions in Japan. Patients diagnosed as having SAP according to the Japanese Severity Score between January 2009 and December 2013 were included. We compared the effect of LEPP in each segment on mortality. Results A total of 1097 patients were assessed. The numbers of patients with LEPP in the pancreatic head (Ph), body (Pb), or tail (Pt) were 272, 273, and 204 (with some overlaps), respectively. In multivariate analysis, LEPP in Ph and Pt was significantly related to mortality (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.11-3.40 [P < 0.05], for LEPP in Ph; OR, 2.44; 95% CI, 1.27-4.67 [P < 0.05], for LEPP in Pt), but LEPP in Pb was unrelated to mortality (OR, 0.70; 95% CI, 0.35-1.37; P = 0.30). Conclusions Presence of LEPP in Ph and Pt on early contrast-enhanced computed tomography was independently associated with increased mortality in SAP. These patients require close observation to ensure timely and adequate intervention.

Original languageEnglish
Pages (from-to)867-873
Number of pages7
JournalPancreas
Volume46
Issue number7
DOIs
Publication statusPublished - 2017 Aug 1

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Pancreatitis
Multicenter Studies
Cohort Studies
Tomography
Mortality
Odds Ratio
Confidence Intervals
Japan
Multivariate Analysis
Retrospective Studies
Observation

Keywords

  • contrast-enhanced computed tomography
  • low enhanced pancreatic parenchyma
  • mortality
  • pancreatic head and tail
  • severe acute pancreatitis

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

Cite this

The Prognosis of Severe Acute Pancreatitis Varies According to the Segment Presenting with Low Enhanced Pancreatic Parenchyma on Early Contrast-Enhanced Computed Tomography : A Multicenter Cohort Study. / Kitamura, Katsuya; Horibe, Masayasu; Sanui, Masamitsu; Sasaki, Mitsuhito; Yamamiya, Akira; Ishii, Yu; Yoshida, Hitoshi; Sawano, Hirotaka; Goto, Takashi; Ikeura, Tsukasa; Hamada, Tsuyoshi; Oda, Takuya; Yasuda, Hideto; Ogura, Yuki; Miyazaki, Dai; Hirose, Kaoru; Chiba, Nobutaka; Ozaki, Tetsu; Yamashita, Takahiro; Koinuma, Toshitaka; Oshima, Taku; Yamamoto, Tomonori; Hirota, Morihisa; Azumi, Yoshinori; Nagata, Keiji; Saito, Nobuyuki; Sato, Mizuki; Miyamoto, Kyohei; Iwasaki, Eisuke; Kanai, Takanori; Mayumi, Toshihiko.

In: Pancreas, Vol. 46, No. 7, 01.08.2017, p. 867-873.

Research output: Contribution to journalArticle

Kitamura, K, Horibe, M, Sanui, M, Sasaki, M, Yamamiya, A, Ishii, Y, Yoshida, H, Sawano, H, Goto, T, Ikeura, T, Hamada, T, Oda, T, Yasuda, H, Ogura, Y, Miyazaki, D, Hirose, K, Chiba, N, Ozaki, T, Yamashita, T, Koinuma, T, Oshima, T, Yamamoto, T, Hirota, M, Azumi, Y, Nagata, K, Saito, N, Sato, M, Miyamoto, K, Iwasaki, E, Kanai, T & Mayumi, T 2017, 'The Prognosis of Severe Acute Pancreatitis Varies According to the Segment Presenting with Low Enhanced Pancreatic Parenchyma on Early Contrast-Enhanced Computed Tomography: A Multicenter Cohort Study', Pancreas, vol. 46, no. 7, pp. 867-873. https://doi.org/10.1097/MPA.0000000000000851
Kitamura, Katsuya ; Horibe, Masayasu ; Sanui, Masamitsu ; Sasaki, Mitsuhito ; Yamamiya, Akira ; Ishii, Yu ; Yoshida, Hitoshi ; Sawano, Hirotaka ; Goto, Takashi ; Ikeura, Tsukasa ; Hamada, Tsuyoshi ; Oda, Takuya ; Yasuda, Hideto ; Ogura, Yuki ; Miyazaki, Dai ; Hirose, Kaoru ; Chiba, Nobutaka ; Ozaki, Tetsu ; Yamashita, Takahiro ; Koinuma, Toshitaka ; Oshima, Taku ; Yamamoto, Tomonori ; Hirota, Morihisa ; Azumi, Yoshinori ; Nagata, Keiji ; Saito, Nobuyuki ; Sato, Mizuki ; Miyamoto, Kyohei ; Iwasaki, Eisuke ; Kanai, Takanori ; Mayumi, Toshihiko. / The Prognosis of Severe Acute Pancreatitis Varies According to the Segment Presenting with Low Enhanced Pancreatic Parenchyma on Early Contrast-Enhanced Computed Tomography : A Multicenter Cohort Study. In: Pancreas. 2017 ; Vol. 46, No. 7. pp. 867-873.
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abstract = "Objective The aim of this study was to investigate the outcomes of severe acute pancreatitis (SAP) according to the segment presenting with low enhanced pancreatic parenchyma (LEPP) on early contrast-enhanced computed tomography. Methods This was a post hoc analysis of a multicenter, retrospective study conducted at 44 institutions in Japan. Patients diagnosed as having SAP according to the Japanese Severity Score between January 2009 and December 2013 were included. We compared the effect of LEPP in each segment on mortality. Results A total of 1097 patients were assessed. The numbers of patients with LEPP in the pancreatic head (Ph), body (Pb), or tail (Pt) were 272, 273, and 204 (with some overlaps), respectively. In multivariate analysis, LEPP in Ph and Pt was significantly related to mortality (odds ratio [OR], 1.94; 95{\%} confidence interval [CI], 1.11-3.40 [P < 0.05], for LEPP in Ph; OR, 2.44; 95{\%} CI, 1.27-4.67 [P < 0.05], for LEPP in Pt), but LEPP in Pb was unrelated to mortality (OR, 0.70; 95{\%} CI, 0.35-1.37; P = 0.30). Conclusions Presence of LEPP in Ph and Pt on early contrast-enhanced computed tomography was independently associated with increased mortality in SAP. These patients require close observation to ensure timely and adequate intervention.",
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T1 - The Prognosis of Severe Acute Pancreatitis Varies According to the Segment Presenting with Low Enhanced Pancreatic Parenchyma on Early Contrast-Enhanced Computed Tomography

T2 - A Multicenter Cohort Study

AU - Kitamura, Katsuya

AU - Horibe, Masayasu

AU - Sanui, Masamitsu

AU - Sasaki, Mitsuhito

AU - Yamamiya, Akira

AU - Ishii, Yu

AU - Yoshida, Hitoshi

AU - Sawano, Hirotaka

AU - Goto, Takashi

AU - Ikeura, Tsukasa

AU - Hamada, Tsuyoshi

AU - Oda, Takuya

AU - Yasuda, Hideto

AU - Ogura, Yuki

AU - Miyazaki, Dai

AU - Hirose, Kaoru

AU - Chiba, Nobutaka

AU - Ozaki, Tetsu

AU - Yamashita, Takahiro

AU - Koinuma, Toshitaka

AU - Oshima, Taku

AU - Yamamoto, Tomonori

AU - Hirota, Morihisa

AU - Azumi, Yoshinori

AU - Nagata, Keiji

AU - Saito, Nobuyuki

AU - Sato, Mizuki

AU - Miyamoto, Kyohei

AU - Iwasaki, Eisuke

AU - Kanai, Takanori

AU - Mayumi, Toshihiko

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Objective The aim of this study was to investigate the outcomes of severe acute pancreatitis (SAP) according to the segment presenting with low enhanced pancreatic parenchyma (LEPP) on early contrast-enhanced computed tomography. Methods This was a post hoc analysis of a multicenter, retrospective study conducted at 44 institutions in Japan. Patients diagnosed as having SAP according to the Japanese Severity Score between January 2009 and December 2013 were included. We compared the effect of LEPP in each segment on mortality. Results A total of 1097 patients were assessed. The numbers of patients with LEPP in the pancreatic head (Ph), body (Pb), or tail (Pt) were 272, 273, and 204 (with some overlaps), respectively. In multivariate analysis, LEPP in Ph and Pt was significantly related to mortality (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.11-3.40 [P < 0.05], for LEPP in Ph; OR, 2.44; 95% CI, 1.27-4.67 [P < 0.05], for LEPP in Pt), but LEPP in Pb was unrelated to mortality (OR, 0.70; 95% CI, 0.35-1.37; P = 0.30). Conclusions Presence of LEPP in Ph and Pt on early contrast-enhanced computed tomography was independently associated with increased mortality in SAP. These patients require close observation to ensure timely and adequate intervention.

AB - Objective The aim of this study was to investigate the outcomes of severe acute pancreatitis (SAP) according to the segment presenting with low enhanced pancreatic parenchyma (LEPP) on early contrast-enhanced computed tomography. Methods This was a post hoc analysis of a multicenter, retrospective study conducted at 44 institutions in Japan. Patients diagnosed as having SAP according to the Japanese Severity Score between January 2009 and December 2013 were included. We compared the effect of LEPP in each segment on mortality. Results A total of 1097 patients were assessed. The numbers of patients with LEPP in the pancreatic head (Ph), body (Pb), or tail (Pt) were 272, 273, and 204 (with some overlaps), respectively. In multivariate analysis, LEPP in Ph and Pt was significantly related to mortality (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.11-3.40 [P < 0.05], for LEPP in Ph; OR, 2.44; 95% CI, 1.27-4.67 [P < 0.05], for LEPP in Pt), but LEPP in Pb was unrelated to mortality (OR, 0.70; 95% CI, 0.35-1.37; P = 0.30). Conclusions Presence of LEPP in Ph and Pt on early contrast-enhanced computed tomography was independently associated with increased mortality in SAP. These patients require close observation to ensure timely and adequate intervention.

KW - contrast-enhanced computed tomography

KW - low enhanced pancreatic parenchyma

KW - mortality

KW - pancreatic head and tail

KW - severe acute pancreatitis

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