PhD Scientific Days 2022

Clinical Medicine V. (Poster discussion will take place in the Aula during the Coffee Break)

Anticoagulants Decrease Mortality and Major Complication Rates in Moderately Severe and Severe Acute Pancreatitis – a Systematic Review and Meta-analysis

Előadó neve

Dr. Patoni, Cristina

Előadó munkahelye

Center for Translational Medicine, Semmelweis University, 1085 Budapest,Hungary

Előadó telefonszáma

+40746035233

Előadó e-mail címe

patonicristina@gmail.com

Az előadás címe

Anticoagulants Decrease Mortality and Major Complication Rates in Moderately Severe and Severe Acute Pancreatitis – a Systematic Review and Meta-analysis

Szerző(k) neve és munkahelye

Cristina Patoni1,5 Levente Frim2 , Bunduc Stefania1,3,5,6, Veres Dániel 1, Dembrovszky Fanni1,2, Éliás Anna Júlia1,8, Pálinkás Dániel1,7, Hegyi Péter1,2,3,4 Erőss Bálint*1,2,3, Hegyi Jenő Péter*1,3

1Center for Translational Medicine, Semmelweis University, 1085 Budapest,Hungary
2Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
3Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, 1085 Budapest, Hungary
4János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
5Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
6Fundeni Clinical Institute, 022328 Bucharest, Romania
7Military Hospital – State Health Centre, Budapest, Hungary
8Doctoral School of Health Sciences, Semmelweis University, 1085 Budapest, Hungary

Bemutatás módja

Poszter

Szekció

Clinical Medicine V. (Poster discussion will take place in the Aula during the Coffee Break)

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction
Recent studies have suggested that adding anticoagulants (AC) in severe acute pancreatitis (AP) treatment improves prognosis. The proposed mechanism is the inhibition of cytokines and inflammatory mediators release.
Aims
We aimed to investigate the safety and efficacy of anticoagulation addition in the management of acute pancreatitis across all severity stages.
Method
A systematic search was performed on PubMed, Embase, and Cochrane from inception until 15th October 2021, without restrictions. Eligible studies reported on differences in clinical outcomes in AP patients with vs. without anticoagulation therapy (intervention vs. control group). We included both randomized controlled trials (RCT) and observational studies. The random-effects model estimated pooled odds ratios (OR) and mean differences (MD) with 95% confidence interval. The study protocol is registered on PROSPERO, CRD42021283239.
Results
Out of 8552 articles, we included seven in the meta-analysis and nine in the systematic review. Analyses of the RCTs revealed that: mortality is significantly decreased in the anticoagulation group (236 patients) by comparison with the control group (237 patients) [OR 0.24; 95% CI 0.13; 0.45; I2 = 0%]. Moreover, AC treatment was associated with a significantly lower rate of multiple organ failure in the intervention group (219 patients) vs. control (213 patients) [OR 0.33, 95% CI 0.18; 0.63; I2=0%]. Also need for endoscopic/surgical interventions for the management of AP was lower in the intervention group (236 patients) vs. control group (237 patients) [OR 0.41, 95% CI 0,19; 0.90; I2=0%]. Length of hospital stay was shorter in the anticoagulation group (6012 patients) vs. control (6013 patients) [MD -5,48 days, 95% CI -9,87; -1.10; I2=98%]. The analysis included both RCTs and observational studies. Two studies evaluated the risk of bleeding which had a lower incidence in the intervention group.
Conclusion
Based on our results, anticoagulants are safe and reduce the complication rates in moderately severe and severe AP cases. We suggest starting anticoagulation therapy at AP diagnosis since it is associated with an improved prognosis. Further trials are needed to assess the safety of AC in mild AP and evaluate the risk of bleeding.

University and Doctoral School

Other, please specify in the next box

Other university and doctoral school, not listed above

Center for Translational Medicine, Semmelweis University, 1085 Budapest,Hungary

Supervisor

Hegyi Jenő Péter

Publication of my abstract

I give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

6918

Start

10:40

End

10:45

Authors (legacy)

Cristina Patoni1,5 Levente Frim2 , Bunduc Stefania1,3,5,6, Veres Dániel 1, Dembrovszky Fanni1,2, Éliás Anna Júlia1,8, Pálinkás Dániel1,7, Hegyi Péter1,2,3,4 Erőss Bálint*1,2,3, Hegyi Jenő Péter*1,3

1Center for Translational Medicine, Semmelweis University, 1085 Budapest,Hungary
2Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
3Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, 1085 Budapest, Hungary
4János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
5Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
6Fundeni Clinical Institute, 022328 Bucharest, Romania
7Military Hospital – State Health Centre, Budapest, Hungary
8Doctoral School of Health Sciences, Semmelweis University, 1085 Budapest, Hungary