Early discharge in Mild Acute Pancreatitis. Is it possible? Observational prospective study in a tertiary-level hospital

医学 急性胰腺炎 观察研究 不利影响 胰腺炎 前瞻性队列研究 内科学 急诊医学
作者
Sheila Serra‐Pla,Neus García Monforte,Francisco Javier García Borobia,Pere Rebasa,Juan Carlos García Pacheco,Andreu Romaguera Monzonís,Natalia Bejarano González,Salvador Navarro
出处
期刊:Pancreatology [Elsevier BV]
卷期号:17 (5): 669-674 被引量:15
标识
DOI:10.1016/j.pan.2017.07.193
摘要

In acute pancreatitis (AP), first 24 h are crucial as this is the period in which the greatest amount of patients presents an organ failure. This suggests patients with Mild AP (MAP) could be early identified and discharged. This is an observational prospective trial with the aim to demonstrate the safety of early discharge in Mild Acute Pancreatitis (MAP).Observational prospective study in a third level single centre. Consecutive patients with AP from March 2012 to March 2014 were collected.MAP, tolerance to oral intake, control of pain, C Reactive Protein <150 mg/dL and blood ureic nitrogen < 5 mg/dL in two samples.pregnant, lack of family support, active comorbidities, temperature and serum bilirubin elevation. Patients with MAP, who met the inclusion criteria, were discharged within the first 48 h. Readmissions within first week and first 30 days were recorded. Adverse effects related to readmissions were also collected.Three hundred and seventeen episodes were collected of whom 250 patients were diagnosed with MAP. From these, 105 were early discharged. Early discharged patients presented a 30-day readmission rate of 15.2% (16 patients out of 105) corresponding to the readmission rates in Acute Pancreatitis published to date. Any patient presented adverse effects related to readmissions.Early discharge in accurately selected patients with MAP is feasible, safe and efficient and leads to a decrease in median stay with the ensuing savings per process and with no increase in readmissions or inmorbi-mortality.

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