International multidisciplinary survey on the initial management of acute pancreatitis: Perspective of point-of-care specialists focused on daily practice.
J Hepatobiliary Pancreat Sci
; 30(3): 325-337, 2023 Mar.
Article
en En
| MEDLINE
| ID: mdl-35716156
ABSTRACT
BACKGROUND:
The initial management of patients with acute pancreatitis impacts both morbidity and mortality. Point-of-care decisions have been reported to differ from clinical guideline recommendations.METHODS:
An online anonymous questionnaire was distributed through scientific associations and social media using REDCap. Multivariable logistic regression was used to identify the characteristics of participants associated with compliance with the recommendations.RESULTS:
A total of 1054 participants from 94 countries completed the questionnaire; median age (IQR) was 39 (32-47) years; 30.7% were women. Among the participants, 37% opted for nonmoderate flow of i.v. fluid, 31% for fluid type other than Ringer's lactate; 73.4% were in favor of nil per os to patients who could eat, 75.5% for other than enteral feeding to patients with oral intolerance; 15.5% used prophylactic antibiotic in patients with severe acute pancreatitis, 34.1% in necrotizing acute pancreatitis, and 27.4% in patients with systemic inflammatory response syndrome; 27.8% delayed cholecystectomy after biliary acute pancreatitis. Participants with publications in PubMed on acute pancreatitis showed better compliance (OR, 1.62; 95% CI 1.15-2.32; P = .007) with recommendations of the clinical guidelines.CONCLUSIONS:
Feeding and nutrition require the greatest improvement efforts, but also the use of prophylactic antibiotics and timing of cholecystectomy should be improved.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Sistemas de Atención de Punto
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Pancreatitis Aguda Necrotizante
Tipo de estudio:
Guideline
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Prognostic_studies
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Qualitative_research
Límite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
J Hepatobiliary Pancreat Sci
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos