1. Acid suppression therapy, gastrointestinal bleeding and infection in acute pancreatitis - An international cohort study
- Author
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Péter Jenő Hegyi, Áron Vincze, Alexandra Demcsák, László Gajdán, Andrey Litvin, Andra Iulia Suceveanu, Eva Pijoan Comas, Riccardo Casadei, George I Papachristou, Vincenzo Cennamo, Yu-Ting Chang, Péter Hegyi, Ionut Negoi, Carlo Ingaldi, Vitor Nunes, Adriano Quiroga Castiñeira, Lihui Deng, Orestis Ioannidis, Ernő Bóna, Milene Raquel Ramos Moreira e Sá, Juan Armando Rodriguez-Oballe, Andrea Jardi Cuadrado, József Hamvas, Judit Bajor, Alexander Schneider, Tiago Cúrdia Gonçalves, Haluk Tarik Kani, Alexandra Soós, Serge Chooklin, Marcus Hollenbach, Claudio Ricci, Marta Freitas, Isabel Miguel Salas, Michael Hirth, Cristina Tocia, Dóra Illés, Daniel de la Iglesia Garcia, Amir Gougol, Patrícia Sarlós, Marco Marino, Emőke Miklós, Qing Xia, Valentina Negoita, Mihailo Bezmarevic, Radislav Nakov, Erika Darvasi, Deniz Güney Duman, Péter Kanizsai, Laura Mastrangelo, Vasile Sandru, Andrea Párniczky, Hubert Zatorski, Andrea Szentesi, Mária Papp, Mario Pelaez-Luna, Marcel Tantau, Yliya Rabotyagova, Ferenc Izbéki, Natalia V Shirinskaya, Cristian Gheorghe, Ewa Małecka-Panas, Giedrius Barauskas, Engin Altintaş, Wei Huang, Ali Kchaou, Povilas Ignatavicius, Cezar Ciubotaru, Stefania Bunduc, Jorge Paulino Pereira, Dong Wu, Sabite Kacar, Alina Tantau, António Pedro Gomes, Svetlana Turcan, Bálint Erőss, Sorin T. Barbu, Adriana Gherbon, Georgi Minkov, Júlio Constantino, Márk Félix Juhász, Jimin Han, Serhii Chuklin, Klementina Ocskay, Mila Kovacheva-Slavova, Eugen Tcaciuc, Elio Jovine, Lilla Barbara Kincses, Ines Capunge, Gabriel Constantinescu, Bogdan Mateescu, Eugen Dumitru, Ming-Chu Chang, Andrea Soriano Rios, Márta Varga, László Czakó, Volkan Gökbulut, Alexandra Mikó, Szilárd Váncsa, Ahmed Tlili, Demcsak, Alexandra, Soos, Alexandra, Kincses, Lilla, Capunge, Ines, Minkov, Georgi, Kovacheva-Slavova, Mila, Nakov, Radislav, Wu, Dong, Huang, Wei, Xia, Qing, Deng, Lihui, Hollenbach, Marcus, Schneider, Alexander, Hirth, Michael, Ioannidis, Orestis, Vincze, Aron, Bajor, Judit, Sarlos, Patricia, Czako, Laszlo, Illes, Dora, Izbeki, Ferenc, Gajdan, Laszlo, Papp, Maria, Hamvas, Jozsef, Varga, Marta, Kanizsai, Peter, Bona, Erno, Miko, Alexandra, Vancsa, Szilard, Juhasz, Mark Felix, Ocskay, Klementina, Darvasi, Erika, Miklos, Emoke, Eross, Balint, Szentesi, Andrea, Parniczky, Andrea, Casadei, Riccardo, Ricci, Claudio, Ingaldi, Carlo, Mastrangelo, Laura, Jovine, Elio, Cennamo, Vincenzo, Marino, Marco V., Barauskas, Giedrius, Ignatavicius, Povilas, Pelaez-Luna, Mario, Rios, Andrea Soriano, Turcan, Svetlana, Tcaciuc, Eugen, Malecka-Panas, Ewa, Zatorski, Hubert, Nunes, Vitor, Gomes, Antonio, Goncalves, Tiago Curdia, Freitas, Marta, Constantino, Julio, Sa, Milene, Pereira, Jorge, Mateescu, Bogdan, Constantinescu, Gabriel, Sandru, Vasile, Negoi, Ionut, Ciubotaru, Cezar, Negoita, Valentina, Bunduc, Stefania, Gheorghe, Cristian, Barbu, Sorin, Tantau, Alina, Tantau, Marcel, Dumitru, Eugen, Suceveanu, Andra Iulia, Tocia, Cristina, Gherbon, Adriana, Litvin, Andrey, Shirinskaya, Natalia, Rabotyagova, Yliya, Bezmarevic, Mihailo, Hegyi, Peter Jeno, Han, Jimin, Rodriguez-Oballe, Juan Armando, Salas, Isabel Miguel, Comas, Eva Pijoan, de la Iglesia Garcia, Daniel, Cuadrado, Andrea Jardi, Castineira, Adriano Quiroga, Chang, Yu-Ting, Chang, Ming-Chu, Kchaou, Ali, Tlili, Ahmed, Kacar, Sabite, Gokbulut, Volkan, Duman, Deniz, Kani, Haluk Tarik, Altintas, Engin, Chooklin, Serge, Chuklin, Serhii, Gougol, Amir, Papachristou, George, Hegyi, Peter, Demcsak A., Soos A., Kincses L., Capunge I., Minkov G., Kovacheva-Slavova M., Nakov R., Wu D., Huang W., Xia Q., Deng L., Hollenbach M., Schneider A., Hirth M., Ioannidis O., Vincze A., Bajor J., Sarlos P., Czako L., Illes D., Izbeki F., Gajdan L., Papp M., Hamvas J., Varga M., Kanizsai P., Bona E., Miko A., Vancsa S., Juhasz M.F., Ocskay K., Darvasi E., Miklos E., Eross B., Szentesi A., Parniczky A., Casadei R., Ricci C., Ingaldi C., Mastrangelo L., Jovine E., Cennamo V., Marino M.V., Barauskas G., Ignatavicius P., Pelaez-Luna M., Rios A.S., Turcan S., Tcaciuc E., Malecka-Panas E., Zatorski H., Nunes V., Gomes A., Goncalves T.C., Freitas M., Constantino J., Sa M., Pereira J., Mateescu B., Constantinescu G., Sandru V., Negoi I., Ciubotaru C., Negoita V., Bunduc S., Gheorghe C., Barbu S., Tantau A., Tantau M., Dumitru E., Suceveanu A.I., Tocia C., Gherbon A., Litvin A., Shirinskaya N., Rabotyagova Y., Bezmarevic M., Hegyi P.J., Han J., Rodriguez-Oballe J.A., Salas I.M., Comas E.P., Garcia D.D.L.I., Cuadrado A.J., Castineira A.Q., Chang Y.-T., Chang M.-C., Kchaou A., Tlili A., Kacar S., Gokbulut V., Duman D., Kani H.T., Altintas E., Chooklin S., Chuklin S., Gougol A., Papachristou G., and Hegyi P.
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Male ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,Cohort Studies ,Feces ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,Acid suppressing drug ,Acute pancreatitis ,Gastrointestinal bleeding ,Gastrointestinal infection ,Proton pump inhibitor ,Enterocolitis, Pseudomembranous ,Aged, 80 and over ,RISK ,ASSOCIATION ,Middle Aged ,Clostridium difficile ,CANCER ,3. Good health ,Hospitalization ,Treatment Outcome ,030220 oncology & carcinogenesis ,Acute Disease ,Female ,030211 gastroenterology & hepatology ,Gastrointestinal Hemorrhage ,Cohort study ,Adult ,medicine.medical_specialty ,GI bleeding ,medicine.drug_class ,Proton-pump inhibitor ,Infections ,PROTON-PUMP INHIBITORS ,03 medical and health sciences ,Internal medicine ,mental disorders ,medicine ,MANAGEMENT ,Humans ,DRUGS ,Acute pancreatiti ,Aged ,Retrospective Studies ,Hepatology ,Clostridioides difficile ,business.industry ,Proton Pump Inhibitors ,medicine.disease ,Pancreatitis ,Acid suppression ,business - Abstract
Background: Acid suppressing drugs (ASD) are generally used in acute pancreatitis (AP); however, large cohorts are not available to understand their efficiency and safety. Therefore, our aims were to evaluate the association between the administration of ASDs, the outcome of AP, the frequency of gastrointestinal (GI) bleeding and GI infection in patients with AP. Methods: We initiated an international survey and performed retrospective data analysis on AP patients hospitalized between January 2013 and December 2018. Results: Data of 17,422 adult patients with AP were collected from 59 centers of 23 countries. We found that 23.3% of patients received ASDs before and 86.6% during the course of AP. ASDs were prescribed to 57.6% of patients at discharge. ASD administration was associated with more severe AP and higher mortality. GI bleeding was reported in 4.7% of patients, and it was associated with pancreatitis severity, mortality and ASD therapy. Stool culture test was performed in 6.3% of the patients with 28.4% positive results. Clostridium difficile was the cause of GI infection in 60.5% of cases. Among the patients with GI infections, 28.9% received ASDs, whereas 24.1% were without any acid suppression treatment. GI infection was associated with more severe pancreatitis and higher mortality. Conclusions: Although ASD therapy is widely used, it is unlikely to have beneficial effects either on the outcome of AP or on the prevention of GI bleeding during AP. Therefore, ASD therapy should be substantially decreased in the therapeutic management of AP. (C) 2020 IAP and EPC. Published by Elsevier B.V.
- Published
- 2020