The characteristics and prognostic role of acute abdominal on-admission pain in acute pancreatitis A prospective cohort analysis of 1432 cases /

Introduction Pain is the most common symptom in acute pancreatitis (AP) and is among the diagnostic criteria. Therefore, we aimed to characterize acute abdominal pain in AP. Methods The Hungarian Pancreatic Study Group prospectively collected multicentre clinical data on 1435 adult AP patients betwe...

Teljes leírás

Elmentve itt :
Bibliográfiai részletek
Szerzők: Földi Mária
Gede Noémi
Kiss Szabolcs
Vincze Áron
Bajor Judit
Szabó Imre
Szepes Zoltán
Vitális Zsuzsanna
Varjú Péter
Faluhelyi Nándor
Miseta Attila János
Nagy Tamás
Márton Zsolt
Vereczkei András
Hegyi Péter Jenő
Párniczky Andrea
Hegyi Péter
Szentesi Andrea Ildikó
Dokumentumtípus: Cikk
Megjelent: 2022
Sorozat:EUROPEAN JOURNAL OF PAIN 26 No. 3
Tárgyszavak:
doi:10.1002/ejp.1885

mtmt:32508523
Online Access:http://publicatio.bibl.u-szeged.hu/23858
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100 1 |a Földi Mária 
245 1 4 |a The characteristics and prognostic role of acute abdominal on-admission pain in acute pancreatitis  |h [elektronikus dokumentum] :  |b A prospective cohort analysis of 1432 cases /  |c  Földi Mária 
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490 0 |a EUROPEAN JOURNAL OF PAIN  |v 26 No. 3 
520 3 |a Introduction Pain is the most common symptom in acute pancreatitis (AP) and is among the diagnostic criteria. Therefore, we aimed to characterize acute abdominal pain in AP. Methods The Hungarian Pancreatic Study Group prospectively collected multicentre clinical data on 1435 adult AP patients between 2012 and 2017. Pain was characterized by its intensity (mild or intense), duration prior to admission (hours), localization (nine regions of the abdomen) and type (sharp, dull or cramping). Results 97.3% of patients (n = 1394) had pain on admission. Of the initial population with acute abdominal pain, 727 patients answered questions about pain intensity, 1148 about pain type, 1134 about pain localization and 1202 about pain duration. Pain was mostly intense (70%, n = 511/727), characterized by cramping (61%, n = 705/1148), mostly starting less than 24 h prior to admission (56.7%, n = 682/1202). Interestingly, 50.9% of the patients (n = 577/1134) had atypical pain, which means pain other than epigastric or belt-like upper abdominal pain. We observed a higher proportion of peripancreatic fluid collection (19.5% vs. 11.0%; p = 0.009) and oedematous pancreas (8.4% vs. 3.1%; p = 0.016) with intense pain. Sharp pain was associated with AP severity (OR = 2.481 95% CI: 1.550-3.969) and increased mortality (OR = 2.263, 95% CI: 1.199-4.059) compared to other types. Longstanding pain (>72 h) on admission was not associated with outcomes. Pain characteristics showed little association with the patient's baseline characteristics. Conclusion A comprehensive patient interview should include questions about pain characteristics, including pain type. Patients with sharp and intense pain might need special monitoring and tailored pain management. Significance Acute abdominal pain is the leading presenting symptom in acute pancreatitis; however, we currently lack specific guidelines for pain assessment and management. In our cohort analysis, intense and sharp pain on admission was associated with higher odds for severe AP and several systemic and local complications. Therefore, a comprehensive patient interview should include questions about pain characteristics and patients with intense and sharp pain might need closer monitoring. 
650 4 |a Általános orvostudomány 
700 0 1 |a Gede Noémi  |e aut 
700 0 1 |a Kiss Szabolcs  |e aut 
700 0 1 |a Vincze Áron  |e aut 
700 0 1 |a Bajor Judit  |e aut 
700 0 1 |a Szabó Imre  |e aut 
700 0 1 |a Szepes Zoltán  |e aut 
700 0 1 |a Vitális Zsuzsanna  |e aut 
700 0 1 |a Varjú Péter  |e aut 
700 0 1 |a Faluhelyi Nándor  |e aut 
700 0 1 |a Miseta Attila János  |e aut 
700 0 1 |a Nagy Tamás  |e aut 
700 0 1 |a Márton Zsolt  |e aut 
700 0 1 |a Vereczkei András  |e aut 
700 0 1 |a Hegyi Péter Jenő  |e aut 
700 0 1 |a Párniczky Andrea  |e aut 
700 0 1 |a Hegyi Péter  |e aut 
700 0 1 |a Szentesi Andrea Ildikó  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/23858/1/Foldi2022.pdf  |z Dokumentum-elérés