Transition of early-phase treatment for acute pancreatitis: An analysis of nationwide epidemiological survey

Table 1 Required time for acute pancreatitis diagnosis n (%)

	2003 Survey	2007 Survey	2011 Survey	P value
Time for diagnosis
(Total AP)
≤ 12 h	707 (51.6)	806 (58.8)	1148 (61.7)	< 0.00011
13-24 h	288 (21.0)	252 (18.4)	359 (19.3)
25-48 h	156 (11.4)	150 (10.9)	195 (10.5)
49-72 h	95 (6.9)	70 (5.1)	69 (3.7)
≥ 73 h	124 (9.1)	94 (6.8)	89 (4.8)
Time for diagnosis (Severe AP)
≤ 12 h	148 (53.1)	170 (60.9)	240 (66.8)	0.0031
13-24 h	54 (19.3)	51 (18.3)	71 (19.8)
25-48 h	35 (12.5)	31 (11.1)	25 (7.0)
49-72 h	20 (7.2)	15 (5.4)	13 (3.6)
≥ 73 h	22 (7.9)	12 (4.3)	10 (2.8)

¹χ² test. AP: Acute pancreatitis.

Table 2 Prophylactic administration of antibiotics within 24 h n (%)

	2003 survey	2007 survey	2011 survey	P value
Antibiotics (Total AP)
Carbapenem	280 (27.7)	327 (32.5)	689 (36.9)	< 0.00011
Cephem	270 (26.7)	264 (26.2)	485 (26.0)
Cephem/β-lactamase inhibitor combination	429 (42.4)	390 (38.8)	641 (34.4)
Others	33 (3.2)	25 (2.5)	51 (2.7)
Antibiotics (Severe AP)
Carbapenem	86 (41.2)	107 (52.2)	286 (67.3)	< 0.00011
Cephem	54 (25.8)	36 (17.6)	48 (11.3)
Cephem/β-lactamase inhibitor combination	62 (29.7)	57 (27.8)	80 (18.8)
Others	7 (3.3)	5 (2.4)	11 (2.6)

¹χ² test. AP: Acute pancreatitis.

Table 3 Enteral nutrition n (%)

Enteral nutrition(Total AP)	2007 survey	2011 survey	P value
Yes	72 (4.7)	135 (6.2)	0.051
No	1466 (95.3)	2053 (93.8)
Enteral nutrition (Severe AP)	2007 survey	2011 survey	P value
Yes	45 (14.6)	97 (22.4)	0.0081
No	264 (85.4)	337 (77.6)
Enteral nutrition (Severe AP in 2011 survey)	< 500 beds	500 beds or more	P value
Yes	14 (9.9)	83 (28.4)	< 0.00011
No	127 (90.1)	209 (71.6)

¹χ² test. AP: Acute pancreatitis.

Table 4 Trend in continuous regional arterial infusion n (%)

	2003 survey	2007 survey	2011 survey	P value
CRAI (Total AP)
Yes	118 (18.0)	72 (4.5)	95 (4.3)	< 0.00011
No	538 (82.0)	1530 (95.5)	2129 (95.7)
CRAI (Severe AP)
Yes	72 (22.4)	51 (14.6)	76 (17.2)	0.0271
No	249 (77.6)	299 (85.4)	365 (82.8)

¹χ² test. CRAI: Continuous regional arterial infusion; AP: Acute pancreatitis.

Table 5 Continuous regional arterial infusion and mortality

CRAI	2003 survey	2007 survey	2011 survey
(Severe AP)	Mortality	Mortality	Mortality
Yes	15/71 (21.1)	5/49 (10.2)	7/74 (9.5)
No	23/238 (9.7)	27/279 (9.7)	35/327 (10.7)
P value	0.00981	0.909	0.752

¹χ² test. CRAI: Continuous regional arterial infusion; AP: Acute pancreatitis.

Table 6 Factors affecting walled-off necrosis development in severe acute pancreatitis in 2011 survey

	WON (+)	WON (-)	P value
Diagnosis within 48 h	14/17 (82.4)	60/63 (95.2)	0.074
Average amount of fluid resuscitation (mL)	4865.8 ± 2130.2	4661.1 ± 2758.3	0.765
Enteral nutrition	14/22 (63.6)	24/72 (33.3)	0.0111
CRAI	11/23 (47.8)	21/75 (28.0)	0.076

¹χ² test. CRAI: Continuous regional arterial infusion; WON: Walled-off necrosis.

Table 7 Factors affecting surgery requirement in severe acute pancreatitis in 2011 survey

	Surgery (+)	Surgery (-)	P value
Diagnosis within 48 h	16/18 (88.9)	279/300 (94.6)	0.513
Average amount of fluid resuscitation (mL)	6183.6 ± 4109.5	4203.1 ± 2810.6	0.0031
Enteral nutrition	13/25 (52.0)	76/350 (21.7)	0.00062
CRAI	8/25 (32.0)	62/360 (17.2)	0.064

¹t-test;

²χ² test. CRAI: Continuous regional arterial infusion.

Table 8 Factors affecting late (> 4W) acute pancreatitis -related death in severe acute pancreatitis in 2011 survey

	AP-related death (> 4W)	Alive	P value
Diagnosis within 48 h	5/8 (62.5)	286/305 (98.3)	0.0131
Average amount of fluid resuscitation (mL)	5525.0 ± 3415.5	4295.5 ± 2914.7	0.154
Enteral nutrition	6/12 (50.0)	85/354 (24.0)	0.081
CRAI	0/12 (0.0)	76/355 (21.4)	0.138

¹Fisher’s exact test. CRAI: Continuous regional arterial infusion.