Discharge protocol in acute pancreatitis: an international survey and cohort analysis

There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validate...

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Veröffentlicht in:	Scientific Reports Jg. 13; H. 1; S. 22109 - 10
Hauptverfasser:	Sipos, Zoltán, Szentesi, Andrea, Vincze, Áron, Czakó, László, Shirinskaya, Natalia V., Zolotov, Alexandr N., Xia, Liang, He, Wenhua, Sutton, Robert, Szatmary, Peter, Mukherjee, Rajarshi, Burridge, Isobel Saffron, Francisco, Elsa, Aparicio, David, Pinto, Bruno, Gomes, António, Tantau, Vasile Marcel, Sagau, Emanuela Denisa, Tantau, Alina Ioana, Tocia, Cristina, Pando, Elizabeth, Alberti, Piero, Cirera, Arturo, Molero, Xavier, Lee, Hong Sik, Jung, Min Kyu, Kim, Eui Joo, Lee, Sanghyub, Nistal, Reyes Busta, Lesko, Dusan, Fabisiak, Adam, Mykhailo, V. Maksymenko, Olekcandr, A. Tkachenko, Barauskas, Giedrius, Ignatavicius, Povilas, Balaban, Vasile-Daniel, Patoni, Cristina, Gong, Liang, Freitas, Marta, Macedo, Vítor, Beyer, Georg, Koksal, Aydin Seref, Tozlu, Mukaddes, Comas, Eva Pijoan, Głuszek, Stanisław, Rama-Fernández, Alberto, Galego, Marco, de la Iglesia, Daniel, Aykut, Umut Emre, Duman, Deniz Güney, Aslan, Rahmi, Gherbon, Adriana, Deng, Lihui, Huang, Wei, Poropat, Goran, Ricci, Claudio, Negoi, Ionut, Iordache, Florin Mihail, Constantinescu, Gabriel, Altintas, Engin, Balci, Hatice Rizaoglu, Constantino, Júlio, Aveiro, Débora, Chooklin, Serge, Chuklin, Serhii, Göltl, Philipp, Mateescu, Radu Bogdan, Minkov, Georgi Angelov, Mastrangelo, Laura, Jovine, Elio, Zhu, Quping, Fabisiak, Natalia, Nosáková, Lenka, Marino, Marco V., Mickevicius, Artautas, Hollenbach, Marcus, Molcan, Pavol, Tokarev, Mark Valerievich, Ince, Ali Tüzün, Ramírez-Maldonado, Elena, Pencik, Petr, Sarlós, Patricia, Hágendorn, Roland, Szabó, Imre, Czimmer, József, Pár, Gabriella, Varga, Márta, Erőss, Bálint, Váncsa, Szilárd, Márta, Katalin, Hegyi, Péter Jenő, Hussein, Tamás, Kovács, Beáta, Urbán, Orsolya, Fürst, Emese, Tari, Edina, Maurovich-Horvát, Pál, Eperjesi, Orsolya, Deák, Pál Ákos, Hegyi, Péter
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	London Springer Science and Business Media LLC 13.12.2023 Nature Publishing Group UK Nature Publishing Group Nature Portfolio
Schlagworte:	03.02. Klinikai orvostan 692/308 692/4020 Acute Disease Cohort Studies Digestive System Diseases::Pancreatic Diseases::Pancreatitis [DISEASES] enfermedades del sistema digestivo::enfermedades pancreáticas::pancreatitis [ENFERMEDADES] Hospitalization Hospitals - Ingressos i altes Humanities and Social Sciences Humans Medicine multidisciplinary Pancreatitis Pancreatitis; discharge Patient Discharge Q R Science Science (multidisciplinary) Surgery, anesthesiology, intensive care, radiology Surveys terapéutica::asistencia al paciente::terapéutica::asistencia al paciente::hospitalización::alta de pacientes [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] Therapeutics::Patient Care::Therapeutics::Patient Care::Hospitalization::Patient Discharge [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT]
ISSN:	2045-2322, 2045-2322
Online-Zugang:	Volltext
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Zusammenfassung:	There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) p < 0.001), and a lower rate of readmission due to recurrent AP episodes ( p = 0.005). There was no difference in median discharge CRP level among the international cohorts ( p = 0.586). HPSG-protocol resulted in the shortest LOH (6 (5;9) days) and highest median CRP (35.40 (13.78; 68.40) mg/l). Safety was confirmed by the low rate of readmittance (n = 35; 5%). Discharge protocol is necessary in AP. The discharge protocol used in this study is the first clinically proven protocol. Developing and testifying further protocols are needed to better standardize patients’ care.
Bibliographie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-023-48480-z