Delayed referral increases the need for surgery and intervention in patients with acute pancreatitis. Issue 10 (24th August 2020)

• Record Type: Journal Article
• Authors: Muktesh, Gaurav; Samanta, Jayanta; Kumar Singh, Anupam; Gupta, Pankaj; Sinha, Saroj K.; Kumar, Hemant; Gupta, Vikas; Yadav, Thakur D.; Kochhar, Rakesh
• Is Part Of: ANZ journal of surgery. Volume 90:Issue 10(2020)
• Page Start: 2015
• Page End: 2019
• Publication Date: 2020-08-24
• Subjects: acute pancreatitis -- referred presentation -- tertiary care centre; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.16238
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: The aim was to study the outcomes of acute pancreatitis (AP) patients who were referred from other facilities to a tertiary care centre. Methods: Patients with AP were who were referred from other hospitals to a tertiary care centre between April 2013 and September 2019 were studied and their outcomes were analysed. Comparison was made between patients referred early (≤7 days) versus those referred late (>7 days). Results: Of the 838 patients seen by us, 650 patients (77.6%) were referred from other centres. Median (interquartile range) onset to admission interval was 5 (4–7) days for those who were referred ≤7 days and was 16 (11–30) for those who were referred >7 days. Patients referred beyond 7 days of pain onset had higher rates of development of organ failure ( P = 0.007), including acute lung injury ( P = 0.008) and acute kidney injury ( P = 0.026), infected necrosis ( P < 0.0001), requirement of endoscopic/percutaneous drainage ( P < 0.001) and need for surgery ( P < 0.02) compared to patients who were referred ≤7 days of pain onset. Mortality was however similar in the two groups. Conclusion: Patients with AP referred to a specialized centre with AP early (≤7 days) have better outcomes than those referred late (>7 days) from other facilities. Abstract : Patients with acute pancreatitis were who were referred from other hospitals a tertiary care centre were studied and their outcomes were analysed. Subgroup analysis of patients between those referred early (7 days) versus those referred late (>7 days) was done. Patients referred 7 days of pain onset had higher rates of organ failure ( P = 0.007), including acute lung injury ( P = 0.008) and acute kidney injury ( P = 0.026) whereas those referred late had higher infected necrosis ( P < 0.0001), requirement of endoscopic/percutaneous drainage ( P < 0.001) and need for surgery ( P < 0.02).