title: Prospective, Multicentre, Nationwide Clinical Data from 600 Cases of Acute Pancreatitis.
abstract: OBJECTIVE
  The aim of this study was to analyse the clinical characteristics of acute pancreatitis (AP) in a prospectively collected, large, multicentre cohort and to validate the major recommendations in the IAP/APA evidence-based guidelines for the management of AP.
  
  
  METHODS
  Eighty-six different clinical parameters were collected using an electronic clinical research form designed by the Hungarian Pancreatic Study Group.
  
  
  METHODS
  600 adult patients diagnosed with AP were prospectively enrolled from 17 Hungarian centres over a two-year period from 1 January 2013.
  
  
  RESULTS
  With respect to aetiology, biliary and alcoholic pancreatitis represented the two most common forms of AP. The prevalence of biliary AP was higher in women, whereas alcoholic AP was more common in men. Hyperlipidaemia was a risk factor for severity, lack of serum enzyme elevation posed a risk for severe AP, and lack of abdominal pain at admission demonstrated a risk for mortality. Abdominal tenderness developed in all the patients with severe AP, while lack of abdominal tenderness was a favourable sign for mortality. Importantly, lung injury at admission was associated with mortality. With regard to laboratory parameters, white blood cell count and CRP were the two most sensitive indicators for severe AP. The most common local complication was peripancreatic fluid, whereas the most common distant organ failure in severe AP was lung injury. Deviation from the recommendations in the IAP/APA evidence-based guidelines on fluid replacement, enteral nutrition and timing of interventions increased severity and mortality.
  
  
  CONCLUSIONS
  Analysis of a large, nationwide, prospective cohort of AP cases allowed for the identification of important determinants of severity and mortality. Evidence-based guidelines should be observed rigorously to improve outcomes in AP.
authors: Heim Pál Children's Hospital, Budapest, Hungary.
authors: Andrea
authors: A
authors: Párniczky
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Balázs
authors: B
authors: Kui
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.|Institute for Translational Medicine, University of Pécs, Pécs, Hungary.
authors: Andrea
authors: A
authors: Szentesi
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Anita
authors: A
authors: Balázs
authors: First Department of Surgery, Semmelweis University, Budapest, Hungary.
authors: Ákos
authors: Á
authors: Szűcs
authors: Department of Pediatrics, Balassa János Hospital of County Tolna, Szekszárd, Hungary.
authors: Dóra
authors: D
authors: Mosztbacher
authors: First Department of Medicine, University of Pécs, Pécs, Hungary.
authors: József
authors: J
authors: Czimmer
authors: First Department of Medicine, University of Pécs, Pécs, Hungary.
authors: Patrícia
authors: P
authors: Sarlós
authors: First Department of Medicine, University of Pécs, Pécs, Hungary.
authors: Judit
authors: J
authors: Bajor
authors: First Department of Medicine, University of Pécs, Pécs, Hungary.
authors: Szilárd
authors: S
authors: Gódi
authors: First Department of Medicine, University of Pécs, Pécs, Hungary.
authors: Áron
authors: Á
authors: Vincze
authors: First Department of Medicine, University of Pécs, Pécs, Hungary.
authors: Anita
authors: A
authors: Illés
authors: First Department of Medicine, University of Pécs, Pécs, Hungary.
authors: Imre
authors: I
authors: Szabó
authors: First Department of Medicine, University of Pécs, Pécs, Hungary.
authors: Gabriella
authors: G
authors: Pár
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Tamás
authors: T
authors: Takács
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: László
authors: L
authors: Czakó
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Zoltán
authors: Z
authors: Szepes
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors: Zoltán
authors: Z
authors: Rakonczay
authors: Szent György University Teaching Hospital of County Fejér, Székesfehérvár, Hungary.
authors: Ferenc
authors: F
authors: Izbéki
authors: Szent György University Teaching Hospital of County Fejér, Székesfehérvár, Hungary.
authors: Judit
authors: J
authors: Gervain
authors: Szent György University Teaching Hospital of County Fejér, Székesfehérvár, Hungary.
authors: Adrienn
authors: A
authors: Halász
authors: Pándy Kálmán Hospital of County Békés, Gyula, Hungary.
authors: János
authors: J
authors: Novák
authors: Pándy Kálmán Hospital of County Békés, Gyula, Hungary.
authors: Stefan
authors: S
authors: Crai
authors: Bács-Kiskun County University Teaching Hospital, Kecskemét, Hungary.
authors: István
authors: I
authors: Hritz
authors: Healthcare Center of County Csongrád, Makó, Hungary.
authors: Csaba
authors: C
authors: Góg
authors: Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc, Hungary.
authors: János
authors: J
authors: Sümegi
authors: First Department of Medicine, Semmelweis University, Budapest, Hungary.
authors: Petra
authors: P
authors: Golovics
authors: Dr. Réthy Pál Hospital, Békéscsaba, Hungary.
authors: Márta
authors: M
authors: Varga
authors: Dr. Bugyi István Hospital, Szentes, Hungary.
authors: Barnabás
authors: B
authors: Bod
authors: Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
authors: József
authors: J
authors: Hamvas
authors: Institute for Translational Medicine, University of Pécs, Pécs, Hungary.
authors: Mónika
authors: M
authors: Varga-Müller
authors: Institute for Translational Medicine, University of Pécs, Pécs, Hungary.
authors: Zsuzsanna
authors: Z
authors: Papp
authors: Department of Molecular and Cell Biology, Boston University Henry M. Goldman School of Dental Medicine, Boston, United States of America.
authors: Miklós
authors: M
authors: Sahin-Tóth
authors: First Department of Medicine, University of Szeged, Szeged, Hungary.|Institute for Translational Medicine, University of Pécs, Pécs, Hungary.|Hungarian Academy of Sciences - University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group, Szeged, Hungary.
authors: Péter
authors: P
authors: Hegyi
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality / Q000473:pathology; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D010343:Patient Admission; D010808:Physical Examination; D011446:Prospective Studies; D016896:Treatment Outcome