title: Early Predictors of Fluid Sequestration in Acute Pancreatitis: A Validation Study.
abstract: The primary aim of this retrospective study was to externally validate predictors of increased fluid sequestration at 48 hours (FS⁴⁸) in acute pancreatitis (AP).
  
  
  
  Patients admitted between January 10 and February 13 with a diagnosis of AP were evaluated. The FS⁴⁸ was calculated as difference between total fluid input and output in the first 48 hours. Predictors of FS⁴⁸, such as young age, alcoholic etiology, hemoconcentration, hyperglycemia, and systemic inflammatory response syndrome (SIRS), and outcomes in AP, such as increased length of stay, acute fluid collection(s), necrosis, and persistent organ failure (POF), were defined in accordance with the previous study. Linear regression analysis was performed to evaluate the association between predictors and outcome.
  
  
  
  Two hundred twenty-seven AP patients (mean age, 48 years; 54% men) with a median FS⁴⁸ of 4.2 L were evaluated. Age younger than 40 years, alcoholic etiology, hemoconcentration, and SIRS independently predicted increased FS⁴⁸ (P < 0.05). Increased FS⁴⁸ was associated with persistent SIRS and POF (P < 0.01). There was a significant trend between number of predictors and FS (P < 0.001). The presence of 4 predictors or more was associated with higher rates of persistent SIRS and POF (P < 0.01).
  
  
  
  Our study validated 4 of 5 predictors of increased FS⁴⁸ from the previous study. Presence of 4 predictors or more and increased FS⁴⁸ are both associated with persistent SIRS and POF.
authors.affiliation: From the *Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD; †Pancreatic Unit, Hospital General Universitario de Alicante, Alicante, Spain; ‡Department of Radiology and Radiological Sciences, and §Pancreatitis Center, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Amitasha
authors.initials: A
authors.lastname: Sinha
authors.forename: Noé
authors.initials: N
authors.lastname: Quesada-Vázquez
authors.forename: Mahya
authors.initials: M
authors.lastname: Faghih
authors.forename: Elham
authors.initials: E
authors.lastname: Afghani
authors.forename: Atif
authors.initials: A
authors.lastname: Zaheer
authors.forename: Mouen A
authors.initials: MA
authors.lastname: Khashab
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Lennon
authors.forename: Enriqué
authors.initials: E
authors.lastname: de-Madaria
authors.forename: Vikesh K
authors.initials: VK
authors.lastname: Singh
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects; D001826:Body Fluids / Q000378:metabolism*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000378:metabolism; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000378:metabolism; D013997:Time Factors