Association of greater intravenous volume infusion with shorter hospitalization for patients with post-ERCP pancreatitis

• Published in: Journal of gastroenterology and hepatology Vol. 29; no. 6; pp. 1316 - 1320
• Main Authors: Sagi, Sashidhar V, Schmidt, Suzette, Fogel, Evan, Lehman, Glen A, McHenry, Lee, Sherman, Stuart, Watkins, James, Coté, Gregory A
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.06.2014
• Subjects: Adult; Age Factors; Cholangiopancreatography, Endoscopic Retrograde - adverse effects; Cohort Studies; endoscopic retrograde cholangiopancreatography; Female; Humans; Infusions, Intravenous; intravenous infusion; Isotonic Solutions - administration & dosage; Length of Stay; Male; pancreatitis; Pancreatitis - etiology; Pancreatitis - prevention & control; Pancreatitis - therapy; Perioperative Care; Retrospective Studies; Severity of Illness Index; Time Factors; Treatment Outcome; endoscopic retrograde cholangiopancreatography; intravenous infusion; pancreatitis
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.12511

Background and Aim There are no data specifically correlating early intravenous volume infusion (IVI) with the length of hospitalization for postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Methods We conducted a retrospective cohort study of patients admitted within 24 h after ERCP to our institute with PEP. IVI during the first 24 h after ERCP was assessed. Primary outcome was severity of PEP, defined by length of hospitalization according to consensus guidelines: mild ≤ 3, moderate 4–10, and severe > 10 days. Results Of 72 eligible patients, 41 (56.9%) had mild and 31 (43.1%) moderate/severe PEP. Both groups had comparable demographics, indications, and procedural factors except patients with moderate/severe PEP were older (median age 49 vs 36 years, P = 0.05) and more likely to be discharged and readmitted within the first 24 h (41.9% vs 14.6%, P < 0.01). Patients with mild PEP received significantly greater IVI during the first 24 h (2834 mL [2046, 3570] vs 2044 mL [1227, 2875], P < 0.02) and 50% more fluid post‐ERCP (2270 mL [1435, 2961] vs 1515 [950–2350], P < 0.02) compared with those with at least moderate PEP. Conclusion In patients with PEP, greater IVI during the first 24 h after ERCP is associated with reduced length of hospitalization. Lower IVI was more commonly observed in individuals who were discharged and then readmitted during the first 24 h.