Large volume fluid resuscitation for severe acute pancreatitis is associated with reduced mortality: A multicenter retrospective study

Takahiro Yamashita, Masayasu Horibe, Masamitsu Sanui, Mitsuhito Sasaki, Hirotaka Sawano, Takashi Goto, Tsukasa Ikeura, Tsuyoshi Hamada, Takuya Oda, Hideto Yasuda, Yuki Ogura, Dai Miyazaki, Kaoru Hirose, Katsuya Kitamura, Nobutaka Chiba, Tetsu Ozaki, Toshitaka Koinuma, Taku Oshima, Tomonori Yamamoto, Morihisa HirotaYukiko Masuda, Natsuko Tokuhira, Mioko Kobayashi, Shinjiro Saito, Junko Izai, Alan K. Lefor, Eisuke Iwasaki, Takanori Kanai, Toshihiko Mayumi

研究成果: Article

3 引用 (Scopus)

抄録

Background and Aims: Although fluid resuscitation is critical in acute pancreatitis, the optimal fluid volume is unknown. The aim of this study is to evaluate the association between the volume of fluid administered and clinical outcomes in patients with severe acute pancreatitis (SAP). Methods: We conducted a multicenter retrospective study at 44 institutions in Japan. Inclusion criteria were age 18 years or older, and diagnosed with SAP from 2009 to 2013. Patients were stratified into 2 groups: administered fluid volume <6000 and ≥ 6000 mL in the first 24 hours. We evaluated the association between the 2 groups and clinical outcomes using multivariable logistic regression analysis. The primary outcome was in-hospital mortality. Secondary outcomes included the incidence of pancreatic infection and the need for surgical intervention. Results: We analyzed 1097 patients, and the mean fluid volume administered was 5618±3018 mL (mean±SD), with 708 and 389 patients stratified into the fluid <6000 mL and fluid ≥6000 mL groups, respectively. Overall in-hospital mortality was 12.3%. The fluid ≥ 6000 mL group had significantly higher mortality than the fluid <6000 mL group (univariable analysis, 15.9% vs. 10.3%; P<0.05). In multivariable logistic regression analysis, administration of ≥6000 mL of fluid within the first 24 hours was significantly associated with reduced mortality (odds ratio, 0.58; P<0.05). No significant association was found between the administered fluid volume and pancreatic infection, or between the volume administered and the need for surgical intervention. Conclusions: In patients with SAP, administration of a large fluid volume within the first 24 hours is associated with decreased mortality.

元の言語English
ページ(範囲)385-391
ページ数7
ジャーナルJournal of Clinical Gastroenterology
53
発行部数5
DOI
出版物ステータスPublished - 2019 5 1

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Resuscitation
Pancreatitis
Multicenter Studies
Retrospective Studies
Mortality
Hospital Mortality
Logistic Models
Regression Analysis
Infection
Japan
Odds Ratio
Incidence

ASJC Scopus subject areas

  • Gastroenterology

これを引用

Large volume fluid resuscitation for severe acute pancreatitis is associated with reduced mortality : A multicenter retrospective study. / Yamashita, Takahiro; Horibe, Masayasu; Sanui, Masamitsu; Sasaki, Mitsuhito; Sawano, Hirotaka; Goto, Takashi; Ikeura, Tsukasa; Hamada, Tsuyoshi; Oda, Takuya; Yasuda, Hideto; Ogura, Yuki; Miyazaki, Dai; Hirose, Kaoru; Kitamura, Katsuya; Chiba, Nobutaka; Ozaki, Tetsu; Koinuma, Toshitaka; Oshima, Taku; Yamamoto, Tomonori; Hirota, Morihisa; Masuda, Yukiko; Tokuhira, Natsuko; Kobayashi, Mioko; Saito, Shinjiro; Izai, Junko; Lefor, Alan K.; Iwasaki, Eisuke; Kanai, Takanori; Mayumi, Toshihiko.

:: Journal of Clinical Gastroenterology, 巻 53, 番号 5, 01.05.2019, p. 385-391.

研究成果: Article

Yamashita, T, Horibe, M, Sanui, M, Sasaki, M, Sawano, H, Goto, T, Ikeura, T, Hamada, T, Oda, T, Yasuda, H, Ogura, Y, Miyazaki, D, Hirose, K, Kitamura, K, Chiba, N, Ozaki, T, Koinuma, T, Oshima, T, Yamamoto, T, Hirota, M, Masuda, Y, Tokuhira, N, Kobayashi, M, Saito, S, Izai, J, Lefor, AK, Iwasaki, E, Kanai, T & Mayumi, T 2019, 'Large volume fluid resuscitation for severe acute pancreatitis is associated with reduced mortality: A multicenter retrospective study', Journal of Clinical Gastroenterology, 巻. 53, 番号 5, pp. 385-391. https://doi.org/10.1097/MCG.0000000000001046
Yamashita, Takahiro ; Horibe, Masayasu ; Sanui, Masamitsu ; Sasaki, Mitsuhito ; Sawano, Hirotaka ; Goto, Takashi ; Ikeura, Tsukasa ; Hamada, Tsuyoshi ; Oda, Takuya ; Yasuda, Hideto ; Ogura, Yuki ; Miyazaki, Dai ; Hirose, Kaoru ; Kitamura, Katsuya ; Chiba, Nobutaka ; Ozaki, Tetsu ; Koinuma, Toshitaka ; Oshima, Taku ; Yamamoto, Tomonori ; Hirota, Morihisa ; Masuda, Yukiko ; Tokuhira, Natsuko ; Kobayashi, Mioko ; Saito, Shinjiro ; Izai, Junko ; Lefor, Alan K. ; Iwasaki, Eisuke ; Kanai, Takanori ; Mayumi, Toshihiko. / Large volume fluid resuscitation for severe acute pancreatitis is associated with reduced mortality : A multicenter retrospective study. :: Journal of Clinical Gastroenterology. 2019 ; 巻 53, 番号 5. pp. 385-391.
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abstract = "Background and Aims: Although fluid resuscitation is critical in acute pancreatitis, the optimal fluid volume is unknown. The aim of this study is to evaluate the association between the volume of fluid administered and clinical outcomes in patients with severe acute pancreatitis (SAP). Methods: We conducted a multicenter retrospective study at 44 institutions in Japan. Inclusion criteria were age 18 years or older, and diagnosed with SAP from 2009 to 2013. Patients were stratified into 2 groups: administered fluid volume <6000 and ≥ 6000 mL in the first 24 hours. We evaluated the association between the 2 groups and clinical outcomes using multivariable logistic regression analysis. The primary outcome was in-hospital mortality. Secondary outcomes included the incidence of pancreatic infection and the need for surgical intervention. Results: We analyzed 1097 patients, and the mean fluid volume administered was 5618±3018 mL (mean±SD), with 708 and 389 patients stratified into the fluid <6000 mL and fluid ≥6000 mL groups, respectively. Overall in-hospital mortality was 12.3{\%}. The fluid ≥ 6000 mL group had significantly higher mortality than the fluid <6000 mL group (univariable analysis, 15.9{\%} vs. 10.3{\%}; P<0.05). In multivariable logistic regression analysis, administration of ≥6000 mL of fluid within the first 24 hours was significantly associated with reduced mortality (odds ratio, 0.58; P<0.05). No significant association was found between the administered fluid volume and pancreatic infection, or between the volume administered and the need for surgical intervention. Conclusions: In patients with SAP, administration of a large fluid volume within the first 24 hours is associated with decreased mortality.",
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TY - JOUR

T1 - Large volume fluid resuscitation for severe acute pancreatitis is associated with reduced mortality

T2 - A multicenter retrospective study

AU - Yamashita, Takahiro

AU - Horibe, Masayasu

AU - Sanui, Masamitsu

AU - Sasaki, Mitsuhito

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 - Kitamura, Katsuya

AU - Chiba, Nobutaka

AU - Ozaki, Tetsu

AU - Koinuma, Toshitaka

AU - Oshima, Taku

AU - Yamamoto, Tomonori

AU - Hirota, Morihisa

AU - Masuda, Yukiko

AU - Tokuhira, Natsuko

AU - Kobayashi, Mioko

AU - Saito, Shinjiro

AU - Izai, Junko

AU - Lefor, Alan K.

AU - Iwasaki, Eisuke

AU - Kanai, Takanori

AU - Mayumi, Toshihiko

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Background and Aims: Although fluid resuscitation is critical in acute pancreatitis, the optimal fluid volume is unknown. The aim of this study is to evaluate the association between the volume of fluid administered and clinical outcomes in patients with severe acute pancreatitis (SAP). Methods: We conducted a multicenter retrospective study at 44 institutions in Japan. Inclusion criteria were age 18 years or older, and diagnosed with SAP from 2009 to 2013. Patients were stratified into 2 groups: administered fluid volume <6000 and ≥ 6000 mL in the first 24 hours. We evaluated the association between the 2 groups and clinical outcomes using multivariable logistic regression analysis. The primary outcome was in-hospital mortality. Secondary outcomes included the incidence of pancreatic infection and the need for surgical intervention. Results: We analyzed 1097 patients, and the mean fluid volume administered was 5618±3018 mL (mean±SD), with 708 and 389 patients stratified into the fluid <6000 mL and fluid ≥6000 mL groups, respectively. Overall in-hospital mortality was 12.3%. The fluid ≥ 6000 mL group had significantly higher mortality than the fluid <6000 mL group (univariable analysis, 15.9% vs. 10.3%; P<0.05). In multivariable logistic regression analysis, administration of ≥6000 mL of fluid within the first 24 hours was significantly associated with reduced mortality (odds ratio, 0.58; P<0.05). No significant association was found between the administered fluid volume and pancreatic infection, or between the volume administered and the need for surgical intervention. Conclusions: In patients with SAP, administration of a large fluid volume within the first 24 hours is associated with decreased mortality.

AB - Background and Aims: Although fluid resuscitation is critical in acute pancreatitis, the optimal fluid volume is unknown. The aim of this study is to evaluate the association between the volume of fluid administered and clinical outcomes in patients with severe acute pancreatitis (SAP). Methods: We conducted a multicenter retrospective study at 44 institutions in Japan. Inclusion criteria were age 18 years or older, and diagnosed with SAP from 2009 to 2013. Patients were stratified into 2 groups: administered fluid volume <6000 and ≥ 6000 mL in the first 24 hours. We evaluated the association between the 2 groups and clinical outcomes using multivariable logistic regression analysis. The primary outcome was in-hospital mortality. Secondary outcomes included the incidence of pancreatic infection and the need for surgical intervention. Results: We analyzed 1097 patients, and the mean fluid volume administered was 5618±3018 mL (mean±SD), with 708 and 389 patients stratified into the fluid <6000 mL and fluid ≥6000 mL groups, respectively. Overall in-hospital mortality was 12.3%. The fluid ≥ 6000 mL group had significantly higher mortality than the fluid <6000 mL group (univariable analysis, 15.9% vs. 10.3%; P<0.05). In multivariable logistic regression analysis, administration of ≥6000 mL of fluid within the first 24 hours was significantly associated with reduced mortality (odds ratio, 0.58; P<0.05). No significant association was found between the administered fluid volume and pancreatic infection, or between the volume administered and the need for surgical intervention. Conclusions: In patients with SAP, administration of a large fluid volume within the first 24 hours is associated with decreased mortality.

KW - Fluid resuscitation

KW - Mortality

KW - Pancreatic infection

KW - Severe acute pancreatitis

KW - Surgical intervention

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U2 - 10.1097/MCG.0000000000001046

DO - 10.1097/MCG.0000000000001046

M3 - Article

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AN - SCOPUS:85056672119

VL - 53

SP - 385

EP - 391

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 5

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