Scientific Reports (Dec 2023)

Discharge protocol in acute pancreatitis: an international survey and cohort analysis

  • Rita Nagy,
  • Klementina Ocskay,
  • Zoltán Sipos,
  • Andrea Szentesi,
  • Áron Vincze,
  • László Czakó,
  • Ferenc Izbéki,
  • Natalia V. Shirinskaya,
  • Vladimir L. Poluektov,
  • Alexandr N. Zolotov,
  • Yin Zhu,
  • Liang Xia,
  • Wenhua He,
  • Robert Sutton,
  • Peter Szatmary,
  • Rajarshi Mukherjee,
  • Isobel Saffron Burridge,
  • Emma Wauchope,
  • Elsa Francisco,
  • David Aparicio,
  • Bruno Pinto,
  • António Gomes,
  • Vitor Nunes,
  • Vasile Marcel Tantau,
  • Emanuela Denisa Sagau,
  • Alina Ioana Tantau,
  • Andra Iulia Suceveanu,
  • Cristina Tocia,
  • Andrei Dumitru,
  • Elizabeth Pando,
  • Piero Alberti,
  • Arturo Cirera,
  • Xavier Molero,
  • Hong Sik Lee,
  • Min Kyu Jung,
  • Eui Joo Kim,
  • Sanghyub Lee,
  • María Lourdes Ruiz Rebollo,
  • Reyes Busta Nistal,
  • Sandra Izquierdo Santervas,
  • Dusan Lesko,
  • Marek Soltes,
  • Jozef Radonak,
  • Hubert Zatorski,
  • Ewa Małecka-Panas,
  • Adam Fabisiak,
  • M. Susak Yaroslav,
  • V. Maksymenko Mykhailo,
  • A. Tkachenko Olekcandr,
  • Giedrius Barauskas,
  • Vytautas Simanaitis,
  • Povilas Ignatavicius,
  • Mariana Jinga,
  • Vasile-Daniel Balaban,
  • Cristina Patoni,
  • Liang Gong,
  • Kai Song,
  • Yunlong Li,
  • T. Cúrdia Gonçalves,
  • Marta Freitas,
  • Vítor Macedo,
  • Marlies Vornhuelz,
  • Sarah Klauss,
  • Georg Beyer,
  • Aydin Seref Koksal,
  • Mukaddes Tozlu,
  • Ahmet Tarik Eminler,
  • Nuria Torres Monclús,
  • Eva Pijoan Comas,
  • Juan Armando Rodriguez Oballe,
  • Łukasz Nawacki,
  • Stanisław Głuszek,
  • Alberto Rama-Fernández,
  • Marco Galego,
  • Daniel de la Iglesia,
  • Umut Emre Aykut,
  • Deniz Güney Duman,
  • Rahmi Aslan,
  • Adriana Gherbon,
  • Lihui Deng,
  • Wei Huang,
  • Qing Xia,
  • Goran Poropat,
  • Anja Radovan,
  • Luka Vranić,
  • Claudio Ricci,
  • Carlo Ingaldi,
  • Riccardo Casadei,
  • Ionut Negoi,
  • Cezar Ciubotaru,
  • Florin Mihail Iordache,
  • Gabriel Constantinescu,
  • Vasile Sandru,
  • Engin Altintas,
  • Hatice Rizaoglu Balci,
  • Júlio Constantino,
  • Débora Aveiro,
  • Jorge Pereira,
  • Suleyman Gunay,
  • Seda Misirlioglu Sucan,
  • Oleksiy Dronov,
  • Inna Kovalska,
  • Nikhil Bush,
  • Surinder Singh Rana,
  • Serge Chooklin,
  • Serhii Chuklin,
  • Ionut Adrian Saizu,
  • Cristian Gheorghe,
  • Philipp Göltl,
  • Michael Hirth,
  • Radu Bogdan Mateescu,
  • Geanina Papuc,
  • Georgi Angelov Minkov,
  • Emil Tihomirov Enchev,
  • Laura Mastrangelo,
  • Elio Jovine,
  • Weiwei Chen,
  • Quping Zhu,
  • Anita Gąsiorowska,
  • Natalia Fabisiak,
  • Mihailo Bezmarevic,
  • Andrey Litvin,
  • Martina Cattani Mottes,
  • Eun Kwang Choi,
  • Peter Bánovčin,
  • Lenka Nosáková,
  • Mila Dimitrova Kovacheva-Slavova,
  • Ali Kchaou,
  • Ahmed Tlili,
  • Marco V. Marino,
  • Katarzyna Kusnierz,
  • Artautas Mickevicius,
  • Marcus Hollenbach,
  • Pavol Molcan,
  • Orestis Ioannidis,
  • Mark Valerievich Tokarev,
  • Ali Tüzün Ince,
  • Ivan Albertovich Semenenko,
  • Shamil Galeev,
  • Elena Ramírez-Maldonado,
  • Ville Sallinen,
  • Petr Pencik,
  • Judit Bajor,
  • Patricia Sarlós,
  • Roland Hágendorn,
  • Szilárd Gódi,
  • Imre Szabó,
  • József Czimmer,
  • Gabriella Pár,
  • Anita Illés,
  • Nándor Faluhelyi,
  • Péter Kanizsai,
  • Tamás Nagy,
  • Alexandra Mikó,
  • Balázs Németh,
  • József Hamvas,
  • Barnabás Bod,
  • Márta Varga,
  • Imola Török,
  • János Novák,
  • Árpád Patai,
  • János Sümegi,
  • Csaba Góg,
  • Mária Papp,
  • Bálint Erőss,
  • Szilárd Váncsa,
  • Brigitta Teutsch,
  • Katalin Márta,
  • Péter Jenő Hegyi,
  • Tamás Tornai,
  • Balázs Lázár,
  • Tamás Hussein,
  • Dorottya Tarján,
  • Mónika Lipp,
  • Beáta Kovács,
  • Orsolya Urbán,
  • Emese Fürst,
  • Edina Tari,
  • Ibolya Kocsis,
  • Pál Maurovich-Horvát,
  • Balázs Tihanyi,
  • Orsolya Eperjesi,
  • Zita Kormos,
  • Pál Ákos Deák,
  • Andrea Párniczky,
  • Péter Hegyi

DOI
https://doi.org/10.1038/s41598-023-48480-z
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 10

Abstract

Read online

Abstract There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) p < 0.001), and a lower rate of readmission due to recurrent AP episodes (p = 0.005). There was no difference in median discharge CRP level among the international cohorts (p = 0.586). HPSG-protocol resulted in the shortest LOH (6 (5;9) days) and highest median CRP (35.40 (13.78; 68.40) mg/l). Safety was confirmed by the low rate of readmittance (n = 35; 5%). Discharge protocol is necessary in AP. The discharge protocol used in this study is the first clinically proven protocol. Developing and testifying further protocols are needed to better standardize patients’ care.