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Acid suppression therapy, gastrointestinal bleeding and infection in acute pancreatitis: an international cohort study

Background - Acid suppressing drugs (ASD) are generally used in acute pancreatitis (AP); however, large cohorts are not available to understand their efficiency and safety. Therefore, our aims were to evaluate the association between the administration of ASDs, the outcome of AP, the frequency of ga...

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Main Authors: Demcsák, Alexandra (Author) , Soós, Alexandra (Author) , Kincses, Lilla (Author) , Capunge, Ines (Author) , Minkov, Georgi (Author) , Kovacheva-Slavova, Mila (Author) , Nakov, Radislav (Author) , Wu, Dong (Author) , Huang, Wei (Author) , Xia, Qing (Author) , Deng, Lihui (Author) , Hollenbach, Marcus (Author) , Schneider, Alexander (Author) , Hirth, Michael (Author) , Ioannidis, Orestis (Author) , Vincze, Áron (Author) , Bajor, Judit (Author) , Sarlós, Patrícia (Author) , Czakó, László (Author) , Illés, Dóra (Author) , Izbéki, Ferenc (Author) , Gajdán, László (Author) , Papp, Mária (Author) , Hamvas, József (Author) , Varga, Márta (Author) , Kanizsai, Péter (Author) , Bóna, Ernő (Author) , Mikó, Alexandra (Author) , Váncsa, Szilárd (Author) , Juhász, Márk Félix (Author) , Ocskay, Klementina (Author) , Darvasi, Erika (Author) , Miklós, Emőke (Author) , Erőss, Bálint (Author) , Szentesi, Andrea (Author) , Párniczky, Andrea (Author) , Casadei, Riccardo (Author) , Ricci, Claudio (Author) , Ingaldi, Carlo (Author) , Mastrangelo, Laura (Author) , Jovine, Elio (Author) , Cennamo, Vincenzo (Author) , Marino, Marco V. (Author) , Barauskas, Giedrius (Author) , Ignatavicius, Povilas (Author) , Pelaez-Luna, Mario (Author) , Rios, Andrea Soriano (Author) , Turcan, Svetlana (Author) , Tcaciuc, Eugen (Author) , Małecka-Panas, Ewa (Author) , Zatorski, Hubert (Author) , Nunes, Vitor (Author) , Gomes, Antonio (Author) , Gonçalves, Tiago Cúrdia (Author) , Freitas, Marta (Author) , Constantino, Júlio (Author) , Sá, Milene (Author) , Pereira, Jorge (Author) , Mateescu, Bogdan (Author) , Constantinescu, Gabriel (Author) , Sandru, Vasile (Author) , Negoi, Ionut (Author) , Ciubotaru, Cezar (Author) , Negoita, Valentina (Author) , Bunduc, Stefania (Author) , Gheorghe, Cristian (Author) , Barbu, Sorin (Author) , Tantau, Alina (Author) , Tantau, Marcel (Author) , Dumitru, Eugen (Author) , Suceveanu, Andra Iulia (Author) , Tocia, Cristina (Author) , Gherbon, Adriana (Author) , Litvin, Andrey (Author) , Shirinskaya, Natalia (Author) , Rabotyagova, Yliya (Author) , Bezmarevic, Mihailo (Author) , Hegyi, Péter Jenő (Author) , Han, Jimin (Author) , Rodriguez-Oballe, Juan Armando (Author) , Salas, Isabel Miguel (Author) , Comas, Eva Pijoan (Author) , Garcia, Daniel de la Iglesia (Author) , Cuadrado, Andrea Jardi (Author) , Castiñeira, Adriano Quiroga (Author) , Chang, Yu-Ting (Author) , Chang, Ming-Chu (Author) , Kchaou, Ali (Author) , Tlili, Ahmed (Author) , Kacar, Sabite (Author) , Gökbulut, Volkan (Author) , Duman, Deniz (Author) , Kani, Haluk Tarik (Author) , Altintas, Engin (Author) , Chooklin, Serge (Author) , Chuklin, Serhii (Author) , Gougol, Amir (Author) , Papachristou, George (Author) , Hegyi, Péter (Author)
Format: Article (Journal)
Language:English
Published: October 2020
In: Pancreatology
Year: 2020, Volume: 20, Issue: 7, Pages: 1323-1331
ISSN:1424-3911
DOI:10.1016/j.pan.2020.08.009
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.pan.2020.08.009
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S142439032030658X
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Author Notes:Alexandra Demcsák, Alexandra Soós, Lilla Kincses, Ines Capunge, Georgi Minkov, Mila Kovacheva-Slavova, Radislav Nakov, Dong Wu, Wei Huang, Qing Xia, Lihui Deng, Marcus Hollenbach, Alexander Schneider, Michael Hirth, Orestis Ioannidis, Áron Vincze, Judit Bajor, Patrícia Sarlós, László Czakó, Dóra Illés, Ferenc Izbéki, László Gajdán, Mária Papp, József Hamvas, Márta Varga, Péter Kanizsai, Ernő Bóna, Alexandra Mikó, Szilárd Váncsa, Márk Félix Juhász, Klementina Ocskay, Erika Darvasi, Emőke Miklós, Bálint Erőss, Andrea Szentesi, Andrea Párniczky, Riccardo Casadei, Claudio Ricci, Carlo Ingaldi, Laura Mastrangelo, Elio Jovine, Vincenzo Cennamo, Marco V. Marino, Giedrius Barauskas, Povilas Ignatavicius, Mario Pelaez-Luna, Andrea Soriano Rios, Svetlana Turcan, Eugen Tcaciuc, Ewa Małecka-Panas, Hubert Zatorski, Vitor Nunes, Antonio Gomes, Tiago Cúrdia Gonçalves, Marta Freitas, Júlio Constantino, Milene Sá, Jorge Pereira, Bogdan Mateescu, Gabriel Constantinescu, Vasile Sandru, Ionut Negoi, Cezar Ciubotaru, Valentina Negoita, Stefania Bunduc, Cristian Gheorghe, Sorin Barbu, Alina Tantau, Marcel Tantau, Eugen Dumitru, Andra Iulia Suceveanu, Cristina Tocia, Adriana Gherbon, Andrey Litvin, Natalia Shirinskaya, Yliya Rabotyagova, Mihailo Bezmarevic, Péter Jenő Hegyi, Jimin Han, Juan Armando Rodriguez-Oballe, Isabel Miguel Salas, Eva Pijoan Comas, Daniel de la Iglesia Garcia, Andrea Jardi Cuadrado, Adriano Quiroga Castiñeira, Yu-Ting Chang, Ming-Chu Chang, Ali Kchaou, Ahmed Tlili, Sabite Kacar, Volkan Gökbulut, Deniz Duman, Haluk Tarik Kani, Engin Altintas, Serge Chooklin, Serhii Chuklin, Amir Gougol, George Papachristou, Péter Hegyi

MARC

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520 |a Background - Acid suppressing drugs (ASD) are generally used in acute pancreatitis (AP); however, large cohorts are not available to understand their efficiency and safety. Therefore, our aims were to evaluate the association between the administration of ASDs, the outcome of AP, the frequency of gastrointestinal (GI) bleeding and GI infection in patients with AP. - Methods - We initiated an international survey and performed retrospective data analysis on AP patients hospitalized between January 2013 and December 2018. - Results - Data of 17,422 adult patients with AP were collected from 59 centers of 23 countries. We found that 23.3% of patients received ASDs before and 86.6% during the course of AP. ASDs were prescribed to 57.6% of patients at discharge. ASD administration was associated with more severe AP and higher mortality. GI bleeding was reported in 4.7% of patients, and it was associated with pancreatitis severity, mortality and ASD therapy. Stool culture test was performed in 6.3% of the patients with 28.4% positive results. Clostridium difficile was the cause of GI infection in 60.5% of cases. Among the patients with GI infections, 28.9% received ASDs, whereas 24.1% were without any acid suppression treatment. GI infection was associated with more severe pancreatitis and higher mortality. - Conclusions - Although ASD therapy is widely used, it is unlikely to have beneficial effects either on the outcome of AP or on the prevention of GI bleeding during AP. Therefore, ASD therapy should be substantially decreased in the therapeutic management of AP. 
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