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Incidence and outcomes of pancreatic encephalopathy in patients with acute pancreatitis: a systematic review and meta-analysis

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Abstract

Pancreatic encephalopathy (PE) is a lethal complication of acute pancreatitis (AP), but its clinical characteristics and prognosis remain obscure. Herein, we performed a systematic review and meta-analysis to evaluate the incidence and outcomes of PE in AP patients. PubMed, EMBASE, and China National Knowledge Infrastructure were searched. Based on the data from cohort studies, the incidence and mortality of PE in AP patients were pooled. Based on the individual data from case reports, logistic regression analyses were performed to identify the risk factors for death in PE patients. Among 6702 papers initially identified, 148 were included. Based on 68 cohort studies, the pooled incidence and mortality of PE in AP patients were 11% and 43%, respectively. The causes of death were clearly reported in 282 patients, of which the most common was multiple organ failure (n = 197). Based on 80 case reports, 114 AP patients with PE were included. The causes of death were clearly reported in 19 patients, of which the most common was multiple organ failure (n = 8). Univariate analyses showed that multiple organ failure (OR = 5.946; p = 0.009) and chronic cholecystitis (OR = 5.400; p = 0.008) were the significant risk factors of death among patients with PE. PE is not a rare complication of AP and indicates poor prognosis. Such a high mortality of PE patients may be attributed to its coexistence of multiple organ failure.

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Data availability

All data reported in this study were available upon request by contact with the corresponding author.

Abbreviations

PE:

Pancreatic encephalopathy

AP:

Acute pancreatitis

SAP:

Severe acute pancreatitis

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analysis

CNKI:

China National Knowledge Infrastructure

APACH II:

Acute Physiology and Chronic Health Evaluation II

NOS:

Newcastle–Ottawa Scale

JBI:

Joanna Briggs Institute

OR:

Odds ratios

CIs:

Confidence intervals

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Funding

Dr. Hongyu Li received the funding from the National Key Research and Development Program of China (2019YFC1315901).

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Author notes

  1. Yao Meng, Xiaojie Zheng, and Fangbo Gao contributed as co-first authors.

Authors and Affiliations

  1. Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, 110840, China

    Yao Meng, Xiaojie Zheng, Fangbo Gao, Lan Chen, Hongyu Li & Xingshun Qi

  2. Postgraduate College, Dalian Medical University, Dalian, 116000, China

    Yao Meng

  3. Postgraduate College, China Medical University, Shenyang, 110122, China

    Xiaojie Zheng

  4. Department of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, 110016, China

    Fangbo Gao

  5. Postgraduate College, Jinzhou Medical University, Jinzhou, 121001, China

    Lan Chen

  6. Department of Neurology, General Hospital of Northern Theater Command, Shenyang, 110840, China

    Jing Qiu

Authors
  1. Yao Meng
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  2. Xiaojie Zheng
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  4. Lan Chen
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  5. Jing Qiu
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  6. Hongyu Li
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  7. Xingshun Qi
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Contributions

Conceptualization: XQ; Methodology: YM, XZ, FG, and XQ; Data curation: YM, XZ, FG, and LC; Formal analysis and data interpretation: YM, XZ, FG, LC, JQ, HL, and XQ; Writing-original draft: YM and XQ; Writing-review and editing: YM, XZ, FG, LC, JQ, HL, and XQ; Supervision: HL and XQ. All authors have made an intellectual contribution to the manuscript and approved the submission.

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Correspondence to Xingshun Qi.

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Meng, Y., Zheng, X., Gao, F. et al. Incidence and outcomes of pancreatic encephalopathy in patients with acute pancreatitis: a systematic review and meta-analysis. Intern Emerg Med 18, 1203–1212 (2023). https://doi.org/10.1007/s11739-023-03243-6

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  • DOI: https://doi.org/10.1007/s11739-023-03243-6

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