The effect of non-steroidal anti-inflammatory drugs on severity of acute pancreatitis and pancreatic necrosis
The effect of non-steroidal anti-inflammatory drugs on severity of acute pancreatitis and pancreatic necrosis
Introduction Acute pancreatitis (AP) is a common emergency presentation and can be disabling. There is significant morbidity and mortality associated with AP, and it places a considerable burden on the healthcare system. Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to have a protective effect in some elective contexts. This retrospective study aimed to evaluate the effect of NSAIDs on the course of AP and the severity of the disease. Methods A retrospective analysis was carried out of 324 patients admitted as an emergency with a diagnosis of AP to two UK hospitals. Patients were divided into two groups: those already taking NSAIDs for other co-morbidities and those not taking NSAIDs. Variables compared included: admission to a high dependency or intensive care unit; pancreatic necrosis; pseudocyst development; need for surgery; serum inflammatory markers; modified early warning scores on days 1, 3 and 5; length of stay; and mortality. Results Patients not taking NSAIDs were more likely to have a C-reactive protein level of ≥150mg/l (p=0.007). Patients in the NSAID group experienced less pancreatic necrosis (p=0.019) and lower rates of pseudocyst formation (p=0.010). Other variables showed no difference between the two groups, specifically length of stay and mortality. Conclusions Routine NSAID use may exert a protective effect on the development of AP, its severity, and complications. Therapeutic use of NSAIDs in acute presentations with pancreatitis should be further evaluated.
Acute Disease, Adult, Aged, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Disease Progression, Female, Humans, Length of Stay/statistics & numerical data, Male, Middle Aged, Pancreatitis/diagnosis, Pancreatitis, Acute Necrotizing/diagnosis, Protective Factors, Retrospective Studies, Severity of Illness Index, Treatment Outcome
199-202
Baxter, K A
29927c7c-5788-432f-9c31-ac75b3c8076a
Pucher, P H
6b51dabb-77c2-40c6-bfa7-1daa3f82c0a6
Berry, D P
97308fd9-0d70-4014-b085-1c2e64b6ecc5
Elberm, H
02de49f5-66b1-45f9-bced-6499385d01cc
Abu-Hilal, M
384e1c60-8519-4eed-8e92-91775aad4c47
Marangoni, G
7c0615ea-dc3b-4614-b920-f9b69c3a5a74
Hamady, Zaed Z.R.
545a1c81-276e-4341-a420-aa10aa5d8ca8
1 March 2018
Baxter, K A
29927c7c-5788-432f-9c31-ac75b3c8076a
Pucher, P H
6b51dabb-77c2-40c6-bfa7-1daa3f82c0a6
Berry, D P
97308fd9-0d70-4014-b085-1c2e64b6ecc5
Elberm, H
02de49f5-66b1-45f9-bced-6499385d01cc
Abu-Hilal, M
384e1c60-8519-4eed-8e92-91775aad4c47
Marangoni, G
7c0615ea-dc3b-4614-b920-f9b69c3a5a74
Hamady, Zaed Z.R.
545a1c81-276e-4341-a420-aa10aa5d8ca8
Baxter, K A, Pucher, P H, Berry, D P, Elberm, H, Abu-Hilal, M, Marangoni, G and Hamady, Zaed Z.R.
(2018)
The effect of non-steroidal anti-inflammatory drugs on severity of acute pancreatitis and pancreatic necrosis.
Annals of The Royal College of Surgeons of England, 100 (3), .
(doi:10.1308/rcsann.2017.0205).
Abstract
Introduction Acute pancreatitis (AP) is a common emergency presentation and can be disabling. There is significant morbidity and mortality associated with AP, and it places a considerable burden on the healthcare system. Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to have a protective effect in some elective contexts. This retrospective study aimed to evaluate the effect of NSAIDs on the course of AP and the severity of the disease. Methods A retrospective analysis was carried out of 324 patients admitted as an emergency with a diagnosis of AP to two UK hospitals. Patients were divided into two groups: those already taking NSAIDs for other co-morbidities and those not taking NSAIDs. Variables compared included: admission to a high dependency or intensive care unit; pancreatic necrosis; pseudocyst development; need for surgery; serum inflammatory markers; modified early warning scores on days 1, 3 and 5; length of stay; and mortality. Results Patients not taking NSAIDs were more likely to have a C-reactive protein level of ≥150mg/l (p=0.007). Patients in the NSAID group experienced less pancreatic necrosis (p=0.019) and lower rates of pseudocyst formation (p=0.010). Other variables showed no difference between the two groups, specifically length of stay and mortality. Conclusions Routine NSAID use may exert a protective effect on the development of AP, its severity, and complications. Therapeutic use of NSAIDs in acute presentations with pancreatitis should be further evaluated.
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e-pub ahead of print date: 28 November 2017
Published date: 1 March 2018
Additional Information:
© The Royal College of Surgeons of England
Keywords:
Acute Disease, Adult, Aged, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Disease Progression, Female, Humans, Length of Stay/statistics & numerical data, Male, Middle Aged, Pancreatitis/diagnosis, Pancreatitis, Acute Necrotizing/diagnosis, Protective Factors, Retrospective Studies, Severity of Illness Index, Treatment Outcome
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Local EPrints ID: 457896
URI: http://eprints.soton.ac.uk/id/eprint/457896
ISSN: 0035-8843
PURE UUID: c09862dc-3ce1-40c7-b0e7-86f5c018d8dc
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Date deposited: 21 Jun 2022 18:15
Last modified: 17 Mar 2024 04:12
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Author:
K A Baxter
Author:
P H Pucher
Author:
D P Berry
Author:
H Elberm
Author:
M Abu-Hilal
Author:
G Marangoni
Author:
Zaed Z.R. Hamady
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