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Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis
PURPOSE: There have been many efforts to develop generalizable severity markers in children with acute pancreatitis (AP). Expert opinion panels have developed consensus guidelines on management but it is unclear if these are sufficient or valid. Our study aims to assess the effect of clinical and la...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354873/ https://www.ncbi.nlm.nih.gov/pubmed/32704496 http://dx.doi.org/10.5223/pghn.2020.23.4.356 |
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author | Shahein, Abdul R. Quiros, J. Antonio Arbizu, Ricardo A. Jump, Candi Lauzon, Steven D. Baker, Susan S. |
author_facet | Shahein, Abdul R. Quiros, J. Antonio Arbizu, Ricardo A. Jump, Candi Lauzon, Steven D. Baker, Susan S. |
author_sort | Shahein, Abdul R. |
collection | PubMed |
description | PURPOSE: There have been many efforts to develop generalizable severity markers in children with acute pancreatitis (AP). Expert opinion panels have developed consensus guidelines on management but it is unclear if these are sufficient or valid. Our study aims to assess the effect of clinical and laboratory variables, in addition to treatment modality on hospital length of stay (LOS) as a proxy variable for severity in pediatric patients admitted with AP. METHODS: We conducted a retrospective chart review of patients between ages of 0–18 years, who were admitted with AP at 2 institutions between 2013–2018, John R. Oishei Children's Hospital (Buffalo, NY, USA) and Medical University of South Carolina Children's Hospital (Charleston, SC, USA). We constructed three linear regression models to analyze the effect of clinical signs of organ dysfunction, laboratory markers and fluid intake on hospital LOS. RESULTS: Ninety-two patients were included in the study. The mean age was 12 years (range, 7.6–17.4 years), 55% were females, and median LOS was 3 days. The most frequent cause of AP was idiopathic. Our study showed that elevated blood urea nitrogen (BUN) on admission (p<0.005), tachycardia that lasted for ≥48 hours (p<0.001) and need for fluid resuscitation were associated with increase LOS. Total daily fluid intake above maintenance did not have a significant effect on the primary outcome (p=0.49). CONCLUSION: Elevated serum BUN on admission, persistent tachycardia and need for fluid resuscitation were associated with increase LOS in pediatric AP. Daily total fluid intake above recommended maintenance did not reduce LOS. |
format | Online Article Text |
id | pubmed-7354873 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition |
record_format | MEDLINE/PubMed |
spelling | pubmed-73548732020-07-22 Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis Shahein, Abdul R. Quiros, J. Antonio Arbizu, Ricardo A. Jump, Candi Lauzon, Steven D. Baker, Susan S. Pediatr Gastroenterol Hepatol Nutr Original Article PURPOSE: There have been many efforts to develop generalizable severity markers in children with acute pancreatitis (AP). Expert opinion panels have developed consensus guidelines on management but it is unclear if these are sufficient or valid. Our study aims to assess the effect of clinical and laboratory variables, in addition to treatment modality on hospital length of stay (LOS) as a proxy variable for severity in pediatric patients admitted with AP. METHODS: We conducted a retrospective chart review of patients between ages of 0–18 years, who were admitted with AP at 2 institutions between 2013–2018, John R. Oishei Children's Hospital (Buffalo, NY, USA) and Medical University of South Carolina Children's Hospital (Charleston, SC, USA). We constructed three linear regression models to analyze the effect of clinical signs of organ dysfunction, laboratory markers and fluid intake on hospital LOS. RESULTS: Ninety-two patients were included in the study. The mean age was 12 years (range, 7.6–17.4 years), 55% were females, and median LOS was 3 days. The most frequent cause of AP was idiopathic. Our study showed that elevated blood urea nitrogen (BUN) on admission (p<0.005), tachycardia that lasted for ≥48 hours (p<0.001) and need for fluid resuscitation were associated with increase LOS. Total daily fluid intake above maintenance did not have a significant effect on the primary outcome (p=0.49). CONCLUSION: Elevated serum BUN on admission, persistent tachycardia and need for fluid resuscitation were associated with increase LOS in pediatric AP. Daily total fluid intake above recommended maintenance did not reduce LOS. The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 2020-07 2020-07-03 /pmc/articles/PMC7354873/ /pubmed/32704496 http://dx.doi.org/10.5223/pghn.2020.23.4.356 Text en Copyright © 2020 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition https://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Shahein, Abdul R. Quiros, J. Antonio Arbizu, Ricardo A. Jump, Candi Lauzon, Steven D. Baker, Susan S. Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis |
title | Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis |
title_full | Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis |
title_fullStr | Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis |
title_full_unstemmed | Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis |
title_short | Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis |
title_sort | impact of clinical, laboratory and fluid therapy variables on hospital length of stay for children with acute pancreatitis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354873/ https://www.ncbi.nlm.nih.gov/pubmed/32704496 http://dx.doi.org/10.5223/pghn.2020.23.4.356 |
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