A Nationwide Analysis of Fluid Resuscitation Outcomes in Patients With Acute Pancreatitis

被引:0
|
作者
Tomanguillo, Julton [1 ]
Searls, Lauren [1 ]
Annie, Frank H. [2 ]
Kemper, Suzanne [3 ]
Drabish, Kerry [4 ]
Naravadi, Vishnu [5 ]
机构
[1] Charleston Area Med Ctr CAMC Inst Acad Med, Internal Med, Charleston, WV USA
[2] Charleston Area Med Ctr CAMC Inst Acad Med, Cardiol, Charleston, WV 25304 USA
[3] Charleston Area Med Ctr CAMC Hlth Educ & Res Inst, Outcomes Res, Charleston, WV USA
[4] Charleston Area Med Ctr CAMC Inst Acad Med, Res, Charleston, WV USA
[5] Charleston Area Med Ctr CAMC Inst Acad Med, Gastroenterol, Charleston, WV USA
关键词
treatment outcomes; resuscitation; pancreatitis; infusion intravenous; fluid therapy; THERAPY; CONSTRICTION; MANAGEMENT;
D O I
10.7759/cureus.50182
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Traditionally, fluid resuscitation has been the foundation of effective acute pancreatitis (AP) treatment. Experts advocate for aggressive intravenous fluid (IVF) resuscitation, especially within the first 24 hours. Research suggests limited efficacy of this approach; in fact, some studies show there may be a risk of increased complications. The aim of this study was to assess outcomes of aggressive IVF resuscitation in patients with AP. Methods: We queried the TriNetX Research Network (Cambridge, Massachusetts, United States) for patients admitted between January 1, 2010, and December 31, 2020, with a diagnosis of AP and who had received IVF on admission for at least 24 hours. We compared two cohorts; cohort 1 consisted of patients receiving aggressive IVF resuscitation (>3 ml/kg/hr), and cohort 2 was comprised of patients receiving non-aggressive (<= 1.5 ml/kg/hr) IVF resuscitation. We compared mortality during index hospitalization, hospital length of stay (HLS), mechanical ventilation rates, acute kidney injury (AKI), and severe sepsis between the cohorts with propensity scoring matched (PSM) pairs of patients. A sub-analysis of patients with severe AP was performed. Results: After comparing the two well-matched PSM cohorts (3,680/3,680), we found no significant differences in mortality, HLS, mechanical ventilation rates, AKI, or severe sepsis. We found similar results after conducting the sub-analysis of patients with severe pancreatitis. Conclusions: We found no significant differences in mortality and HLS when comparing rates of IVF resuscitation.
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页数:6
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