title: Time period from onset of pain to hospital admission and patients' awareness in acute pancreatitis.
abstract: OBJECTIVE
  This study aimed to explore the period between onset of pain and hospital-admission (pain-to-admission time) in patients with acute pancreatitis (AP), to investigate the prognostic value and associated factors of this time, and to ascertain the knowledge about the pancreas in these patients.
  
  
  METHODS
  An analysis of a prospective multicenter study was done, which included 188 patients with AP.
  
  
  RESULTS
  Median pain-to-admission time was 27 hours (interquartile range, 6.0-72.0). Median pain-to-admission time was significantly shorter in intensive care unit (ICU) patients (10 hours) compared to non-ICU patients (36 hours) (P = 0.045). Short pain-to-admission time was associated with high pain level. Median pain level (0, no pain; 10, maximal pain) was 8.0 (interquartile range, 7.0-10.0). Older age correlated with lower pain level (r = -0.26; P = 0.002). Multiple logistic regression analysis including the admission values for serum lipase and C-reactive protein and the corresponding interactions to the pain-to-admission time showed substantial discriminative ability regarding ICU admission (concordance index, 0.706; P = 0.006). 86% (112/130) knew that they have a pancreas, 72% (81/112) of these patients knew that AP exists, and 56% (45/81) recognized that AP is potentially fatal.
  
  
  CONCLUSIONS
  Knowledge about AP in hospitalized AP patients is poor. Serum lipase and C-reactive protein in dependency of the pain-to-admission time might be a suitable predictor for severity of AP.
authors.affiliation: II. Medizinische Klinik und Poliklinik, Institut für Medizinische Statistik und Epidemiologie, Klinikum rechts der Isar der Technischen Universität München, Germany. veit.phillip@lrz.tum.de
authors.forename: Veit
authors.initials: V
authors.lastname: Phillip
authors.forename: Tibor
authors.initials: T
authors.lastname: Schuster
authors.forename: Frank
authors.initials: F
authors.lastname: Hagemes
authors.forename: Sandra
authors.initials: S
authors.lastname: Lorenz
authors.forename: Ulrike
authors.initials: U
authors.lastname: Matheis
authors.forename: Sigrid
authors.initials: S
authors.lastname: Preinfalk
authors.forename: Florian
authors.initials: F
authors.lastname: Lippl
authors.forename: Bernd
authors.initials: B
authors.lastname: Saugel
authors.forename: Roland M
authors.initials: RM
authors.lastname: Schmid
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Huber
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007362:Intensive Care Units; D008049:Lipase / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology*; D010343:Patient Admission; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein; D008049:Lipase