Young Age Predicts Acute Pancreatitis Severity in Children

ABSTRACT Objectives: The course and evolution of pediatric acute pancreatitis (AP) is poorly understood. Prognostication models in children perform poorly and lack consensus. We aimed to identify predictors of AP severity, and the risk for AP recurrence. Methods: We retrospectively studied all patie...

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Published inJournal of pediatric gastroenterology and nutrition Vol. 68; no. 5; pp. 720 - 726
Main Authors Galai, Tut, Cohen, Shlomi, Yerushalmy‐Feler, Anat, Weintraub, Yael, Moran‐Lev, Hadar, Amir, Achiya Z.
Format Journal Article
LanguageEnglish
Published United States by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology 01.05.2019
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Abstract ABSTRACT Objectives: The course and evolution of pediatric acute pancreatitis (AP) is poorly understood. Prognostication models in children perform poorly and lack consensus. We aimed to identify predictors of AP severity, and the risk for AP recurrence. Methods: We retrospectively studied all patients hospitalized with AP at a single tertiary center, between January 1995 and June 2016. Patient demographics and admission laboratory data were assessed for severity and recurrence prediction. Results: A total of 68 patients accounting for a total of 117 (15 moderate‐severe) AP episodes were reviewed. Patients with moderate‐severe disease were significantly younger (median [interquartile range (IQR)] of 8.3 [4.0–14.4] vs 13.8 [8.1–16.0] years, P = 0.02). Young age at presentation was associated with odds ratio of 3.8 (confidence interval [CI] 1.2–12.1) for children younger than 12 years and 5.8 (CI 1.6–21.4) for children younger than 6 years for developing moderate‐severe disease. Further subanalysis of the 59 patients with first‐time AP episodes, demonstrated younger age (median [IQR] of 5.3 [2.9–10.4] vs 12.0 [6.3–15.8] years, P = 0.03) and elevated white blood cell count (median [IQR] of 22.8 [11.8–31.3] vs 11.0 [8.1–14.6] 109/L, P < 0.01) of patients with moderate‐severe disease, conferring a risk for moderate‐severe disease with odds ratio of 7.5 (CI 1.5–38.2) for children younger than 6 years and 5.3 (CI 1.1–25.4) for patients with white blood cell count >15 × 109/L, respectively. Fourteen (23.7%) of 59 patients with first‐time episodes had recurrent AP. Analysis of the data at the primary episode failed to identify predictors to indicate future recurrence. Conclusions: In our cohort, only young age (<12 years) predicted AP severity. No parameters were identified to predict future development of AP recurrence.
AbstractList OBJECTIVES:The course and evolution of pediatric acute pancreatitis (AP) is poorly understood. Prognostication models in children perform poorly and lack consensus. We aimed to identify predictors of AP severity, and the risk for AP recurrence. METHODS:We retrospectively studied all patients hospitalized with AP at a single tertiary center, between January 1995 and June 2016. Patient demographics and admission laboratory data were assessed for severity and recurrence prediction. RESULTS:A total of 68 patients accounting for a total of 117 (15 moderate-severe) AP episodes were reviewed. Patients with moderate-severe disease were significantly younger (median [interquartile range (IQR)] of 8.3 [4.0–14.4] vs 13.8 [8.1–16.0] years, P = 0.02). Young age at presentation was associated with odds ratio of 3.8 (confidence interval [CI] 1.2–12.1) for children younger than 12 years and 5.8 (CI 1.6–21.4) for children younger than 6 years for developing moderate-severe disease.Further subanalysis of the 59 patients with first-time AP episodes, demonstrated younger age (median [IQR] of 5.3 [2.9–10.4] vs 12.0 [6.3–15.8] years, P = 0.03) and elevated white blood cell count (median [IQR] of 22.8 [11.8–31.3] vs 11.0 [8.1–14.6] 10/L, P < 0.01) of patients with moderate-severe disease, conferring a risk for moderate-severe disease with odds ratio of 7.5 (CI 1.5–38.2) for children younger than 6 years and 5.3 (CI 1.1–25.4) for patients with white blood cell count >15 × 10/L, respectively. Fourteen (23.7%) of 59 patients with first-time episodes had recurrent AP. Analysis of the data at the primary episode failed to identify predictors to indicate future recurrence. CONCLUSIONS:In our cohort, only young age (<12 years) predicted AP severity. No parameters were identified to predict future development of AP recurrence.
ABSTRACT Objectives: The course and evolution of pediatric acute pancreatitis (AP) is poorly understood. Prognostication models in children perform poorly and lack consensus. We aimed to identify predictors of AP severity, and the risk for AP recurrence. Methods: We retrospectively studied all patients hospitalized with AP at a single tertiary center, between January 1995 and June 2016. Patient demographics and admission laboratory data were assessed for severity and recurrence prediction. Results: A total of 68 patients accounting for a total of 117 (15 moderate‐severe) AP episodes were reviewed. Patients with moderate‐severe disease were significantly younger (median [interquartile range (IQR)] of 8.3 [4.0–14.4] vs 13.8 [8.1–16.0] years, P = 0.02). Young age at presentation was associated with odds ratio of 3.8 (confidence interval [CI] 1.2–12.1) for children younger than 12 years and 5.8 (CI 1.6–21.4) for children younger than 6 years for developing moderate‐severe disease. Further subanalysis of the 59 patients with first‐time AP episodes, demonstrated younger age (median [IQR] of 5.3 [2.9–10.4] vs 12.0 [6.3–15.8] years, P = 0.03) and elevated white blood cell count (median [IQR] of 22.8 [11.8–31.3] vs 11.0 [8.1–14.6] 109/L, P < 0.01) of patients with moderate‐severe disease, conferring a risk for moderate‐severe disease with odds ratio of 7.5 (CI 1.5–38.2) for children younger than 6 years and 5.3 (CI 1.1–25.4) for patients with white blood cell count >15 × 109/L, respectively. Fourteen (23.7%) of 59 patients with first‐time episodes had recurrent AP. Analysis of the data at the primary episode failed to identify predictors to indicate future recurrence. Conclusions: In our cohort, only young age (<12 years) predicted AP severity. No parameters were identified to predict future development of AP recurrence.
The course and evolution of pediatric acute pancreatitis (AP) is poorly understood. Prognostication models in children perform poorly and lack consensus. We aimed to identify predictors of AP severity, and the risk for AP recurrence. We retrospectively studied all patients hospitalized with AP at a single tertiary center, between January 1995 and June 2016. Patient demographics and admission laboratory data were assessed for severity and recurrence prediction. A total of 68 patients accounting for a total of 117 (15 moderate-severe) AP episodes were reviewed. Patients with moderate-severe disease were significantly younger (median [interquartile range (IQR)] of 8.3 [4.0-14.4] vs 13.8 [8.1-16.0] years, P = 0.02). Young age at presentation was associated with odds ratio of 3.8 (confidence interval [CI] 1.2-12.1) for children younger than 12 years and 5.8 (CI 1.6-21.4) for children younger than 6 years for developing moderate-severe disease.Further subanalysis of the 59 patients with first-time AP episodes, demonstrated younger age (median [IQR] of 5.3 [2.9-10.4] vs 12.0 [6.3-15.8] years, P = 0.03) and elevated white blood cell count (median [IQR] of 22.8 [11.8-31.3] vs 11.0 [8.1-14.6] 10/L, P < 0.01) of patients with moderate-severe disease, conferring a risk for moderate-severe disease with odds ratio of 7.5 (CI 1.5-38.2) for children younger than 6 years and 5.3 (CI 1.1-25.4) for patients with white blood cell count >15 × 10/L, respectively. Fourteen (23.7%) of 59 patients with first-time episodes had recurrent AP. Analysis of the data at the primary episode failed to identify predictors to indicate future recurrence. In our cohort, only young age (<12 years) predicted AP severity. No parameters were identified to predict future development of AP recurrence.
OBJECTIVESThe course and evolution of pediatric acute pancreatitis (AP) is poorly understood. Prognostication models in children perform poorly and lack consensus. We aimed to identify predictors of AP severity, and the risk for AP recurrence. METHODSWe retrospectively studied all patients hospitalized with AP at a single tertiary center, between January 1995 and June 2016. Patient demographics and admission laboratory data were assessed for severity and recurrence prediction. RESULTSA total of 68 patients accounting for a total of 117 (15 moderate-severe) AP episodes were reviewed. Patients with moderate-severe disease were significantly younger (median [interquartile range (IQR)] of 8.3 [4.0-14.4] vs 13.8 [8.1-16.0] years, P = 0.02). Young age at presentation was associated with odds ratio of 3.8 (confidence interval [CI] 1.2-12.1) for children younger than 12 years and 5.8 (CI 1.6-21.4) for children younger than 6 years for developing moderate-severe disease.Further subanalysis of the 59 patients with first-time AP episodes, demonstrated younger age (median [IQR] of 5.3 [2.9-10.4] vs 12.0 [6.3-15.8] years, P = 0.03) and elevated white blood cell count (median [IQR] of 22.8 [11.8-31.3] vs 11.0 [8.1-14.6] 10/L, P < 0.01) of patients with moderate-severe disease, conferring a risk for moderate-severe disease with odds ratio of 7.5 (CI 1.5-38.2) for children younger than 6 years and 5.3 (CI 1.1-25.4) for patients with white blood cell count >15 × 10/L, respectively. Fourteen (23.7%) of 59 patients with first-time episodes had recurrent AP. Analysis of the data at the primary episode failed to identify predictors to indicate future recurrence. CONCLUSIONSIn our cohort, only young age (<12 years) predicted AP severity. No parameters were identified to predict future development of AP recurrence.
Author Cohen, Shlomi
Yerushalmy‐Feler, Anat
Amir, Achiya Z.
Moran‐Lev, Hadar
Galai, Tut
Weintraub, Yael
AuthorAffiliation Pediatric Gastroenterology, Hepatology and Nutrition Clinic, Dana-Dwek Childrenʼs Hospital, The Tel-Aviv Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
AuthorAffiliation_xml – name: Pediatric Gastroenterology, Hepatology and Nutrition Clinic, Dana-Dwek Childrenʼs Hospital, The Tel-Aviv Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  givenname: Shlomi
  surname: Cohen
  fullname: Cohen, Shlomi
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  givenname: Anat
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  surname: Weintraub
  fullname: Weintraub, Yael
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  givenname: Achiya Z.
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Snippet ABSTRACT Objectives: The course and evolution of pediatric acute pancreatitis (AP) is poorly understood. Prognostication models in children perform poorly and...
OBJECTIVES:The course and evolution of pediatric acute pancreatitis (AP) is poorly understood. Prognostication models in children perform poorly and lack...
The course and evolution of pediatric acute pancreatitis (AP) is poorly understood. Prognostication models in children perform poorly and lack consensus. We...
OBJECTIVESThe course and evolution of pediatric acute pancreatitis (AP) is poorly understood. Prognostication models in children perform poorly and lack...
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SubjectTerms acute pancreatitis
acute recurrent pancreatitis
childhood
severity prediction
Title Young Age Predicts Acute Pancreatitis Severity in Children
URI https://onlinelibrary.wiley.com/doi/abs/10.1097%2FMPG.0000000000002294
https://www.ncbi.nlm.nih.gov/pubmed/30747814
https://search.proquest.com/docview/2216303409
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