Trial reportUpdates in surgery2023
Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study.
Trial report in Updates in surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04747990 (coMpliAnce With evideNce-based cliniCal Guidelines in the managemenT of Acute biliaRy pancreAtitis), which is not on this map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
coMpliAnce With evideNce-based cliniCal Guidelines in the managemenT of Acute biliaRy pancreAtitis
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparison of the predictive value of different assessment times in the severity and prognostic outcomes of CTSI in patients with acute pancreatitis: a systematic review and meta-analysis.Abdominal radiology (New York) · 2026Pooled it
- Effectiveness and safety of low molecular weight heparin in the management of acute pancreatitis: a systematic review and meta-analysis.World journal of emergency surgery : WJES · 2024Pooled it
- Risk Factors Associated with the Emergence of Multidrug-Resistant Bacteria and Fungal Infections in Walled-Off Pancreatic Necrosis.Antibiotics (Basel, Switzerland) · 2026Article
- Association between peak D-dimer levels within 24 hours of admission and the risk of infected pancreatic necrosis in hyperlipidemic acute pancreatitis: a retrospective analysis.Frontiers in medicine · 2026Article
- Contrast-enhanced CT-based prediction models for early intervention efficacy and in-hospital mortality risk in acute necrotizing pancreatitis with persistent organ failure.European radiology · 2025Article
- Application and Value of Percutaneous Catheter Drainage in Contemporary Surgical Treatment of Pancreatic Necrosis.Digestive diseases and sciences · 2025Review
- Development and validation of an explainable machine learning model for mortality prediction among patients with infected pancreatic necrosis.EClinicalMedicine · 2025Article
- Development of a nomogram for predicting the intraperitoneal rupture of necrotic collection in patients with necrotizing pancreatitis.Frontiers in medicine · 2025Article
- Radiomics and 256-slice-dual-energy CT in the automated diagnosis of mild acute pancreatitis: the innovation of formal methods and high-resolution CT.La Radiologia medica · 2024Article
- Step-up approach for the treatment of infected necrotising pancreatitis: real life data from a single-centre experience with long-term follow-up.BMC gastroenterology · 2024Observational
- A narrative on diversity, equity, and inclusion in surgery: insights from the European Society of Coloproctology and identification of points for action.Updates in surgery · 2024Article
- Clinical course for pancreatic necrosis and pancreatic pseudocysts due to severe acute or chronic pancreatitis.Therapeutic advances in gastroenterology · 2024Article
Corrections and comments
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Authors and funding
22 authors.
Funding
Abstract
The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990).
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