Muktesh G, Samanta J, Kumar Singh A, Gupta P, Sinha SK, Kumar H, Gupta V, Yadav TD, Kochhar R. Delayed referral increases the need for surgery and intervention in patients with acute pancreatitis.
ANZ J Surg 2020;
90:2015-2019. [PMID:
32840036 DOI:
10.1111/ans.16238]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 01/07/2023]
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.
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