Evidence map›Paper›PMID 27311912›Full record

Observational studyBMJ open2016

Identifying risk factors for progression to critical care admission and death among individuals with acute pancreatitis: a record linkage analysis of Scottish healthcare databases.

Damian J Mole, Usha Gungabissoon, Philip Johnston, Lynda Cochrane, Leanne Hopkins, Grant M A Wyper, Christos Skouras, Chris Dibben, Frank Sullivan, Andrew Morris and 3 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Damian J MoleMRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK Clinical Surgery, University of Edinburgh, Edinburgh, UK.
Usha GungabissoonHealthcare Information Factory, Observational Data Analytics Group, Worldwide Epidemiology, GSK, Uxbridge, UK.
Philip JohnstoneDRIS, NHS National Services Scotland, Edinburgh, UK.
Lynda CochraneClinical Statistics Consultants, Dundee, UK.
Leanne HopkinseDRIS, NHS National Services Scotland, Edinburgh, UK.
Grant M A WypereDRIS, NHS National Services Scotland, Edinburgh, UK.
Christos SkourasClinical Surgery, University of Edinburgh, Edinburgh, UK.
Chris DibbenFarr Institute, Edinburgh, UK.
Frank SullivanDepartment of Family and Community Medicine, North York General Hospital, University of Toronto, Toronto, Ontario, Canada.
Andrew MorrisFarr Institute, Edinburgh, UK.
Hester J T WardeDRIS, NHS National Services Scotland, Edinburgh, UK.
Andrew M LawtonHealthcare Information Factory, Observational Data Analytics Group, Worldwide Epidemiology, GSK, Uxbridge, UK.
Peter T DonnanDundee Epidemiology and Biostatistics Unit (DEBU), Division of Population Health Sciences, Medical Research Institute, University of Dundee, Dundee, UK.

Funding

Medical Research Council G0901697Medical Research Council MC_PC_15049Medical Research Council MR/K007017/1Medical Research Council MR/M501633/1
6 · The paper itself

Abstract

objectivesAcute pancreatitis (AP) can initiate systemic complications that require support in critical care (CC). Our objective was to use the unified national health record to define the epidemiology of AP in Scotland, with a specific focus on deterministic and prognostic factors for CC admission in AP.

settingHealth boards in Scotland (n=4).

participantsWe included all individuals in a retrospective observational cohort with at least one episode of AP (ICD10 code K85) occurring in Scotland from 1 April 2009 to 31 March 2012. 3340 individuals were coded as AP.

methodsData from 16 sources, spanning general practice, community prescribing, Accident and Emergency attendances, hospital in-patient, CC and mortality registries, were linked by a unique patient identifier in a national safe haven. Logistic regression and gamma models were used to define independent predictive factors for severe AP (sAP) requiring CC admission or leading to death.

results2053 individuals (61.5% (95% CI 59.8% to 63.2%)) met the definition for true AP (tAP). 368 patients (17.9% of tAP (95% CI 16.2% to 19.6%)) were admitted to CC. Predictors of sAP were pre-existing angina or hypertension, hypocalcaemia and age 30-39 years, if type 2 diabetes mellitus was present. The risk of sAP was lower in patients with multiple previous episodes of AP. In-hospital mortality in tAP was 5.0% (95% CI 4.1% to 5.9%) overall and 21.7% (95% CI 19.9% to 23.5%) in those with tAP necessitating CC admission.

conclusionsNational record-linkage analysis of routinely collected data constitutes a powerful resource to model CC admission and prognosticate death during AP. Mortality in patients with AP who require CC admission remains high.

Indexed as

Disease ProgressionHospital MortalityAcute DiseaseAdultAgedAged, 80 and overCritical CareDatabases, FactualDiabetes Mellitus, Type 2FemaleHumansLogistic ModelsMaleMedical RecordsMiddle AgedPancreatitisacute pancreatitiscritical caremultiple organ dysfunction syndromeorgan failurerecord linkage analysissafe haven

Identifiers

PMID27311912
PMCPMC4916584

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.