coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis): The MANCTRA-1 international audit
- Autori: Podda, M.; Pacella, D.; Pellino, G.; Coccolini, F.; Giordano, A.; Di Saverio, S.; Pata, F.; Ielpo, B.; Virdis, F.; Damaskos, D.; De Simone, B.; Agresta, F.; Sartelli, M.; Leppaniemi, A.; Riboni, C.; Agnoletti, V.; Mole, D.; Kluger, Y.; Catena, F.; Pisanu, A.; Gerardi, C.; Damaskos, D.; Gourgiotis, S.; Poillucci, G.; Jayant, K.; Ferrario, L.; Calvo, M.P.; Wilson, M.; Soggiu, F.; Hamdan, A.; Gomes, C.A.; Fraga, G.; Ioannidis, A.; Demetrashvili, Z.; Sahani, S.; Bains, L.; Khamees, A.; Ababneh, H.; Aljaiuossi, O.; Pimentel, S.; Mohamad, I.S.; Yusoff, A.R.; Zarnescu, N.O.; Calu, V.; Litvin, A.; Lesko, D.; Elmehrath, A.; Elshami, M.; De Santibanes, M.; Gundara, J.; Alawadhi, K.; Lui, R.; Julianov, A.; Ralon, S.; Garzali, I.-.; Machain, G.M.; Quispe-Cruz, D.A.; Orantia, A.C.C.; Waledziak, M.; Correia De Sa, T.; Ali, S.M.; Kovacevic, B.; Noel, C.; Abdalah, H.M.; Kchaou, A.; Isik, A.; Ansaloni, L.; Biffl, W.; Guerrieri, M.; Sartori, A.; Abradelo, M.; Nigri, G.; Di Lorenzo, N.; Mingoli, A.; Chiarugi, M.; Di Menno Stavron, J.; Mazza, O.; Valenzuela, J.I.; Pantoja Pachajoa, D.A.; Alvarez, F.A.; Liano, J.E.; Tefay, J.; Alshaikh, A.; Hasan, L.; Augusto Gomes, C.; Gomes, F.C.; Fraga, G.P.; Calderan, T.R.A.; Hirano, E.S.; Dardanov, D.; Saroglu, A.; Atanasov, B.; Belev, N.; Kovachev, N.; Chan, S.M.; Lok, H.-.; Salcedo, D.; Robayo, D.; Trivino, M.A.; Manak, J.; De Araujo, J.; Sethi, A.; Awad, A.; Elbadawy, M.; Farid, A.; Hanafy, A.; Nafea, A.; Sherief-Ghozy, ; Salah - Abbas, A.; Abdelsalam, W.; Emile, S.; Elfallal, A.; Elfeki, H.; Elghadban, H.; Shoma, A.; Shetiwy, M.; Elbahnasawy, M.; Mohamed, S.; Hamed, E.F.; Khalil, U.A.; Chouillard, E.; Gumbs, A.; Police, A.; Mabilia, A.; Khutsishvili, K.; Tvaladze, A.; Ioannidis, O.; Anestiadou, E.; Loutzidou, L.; Konstantinidis, K.; Konstantinidou, S.; Manatakis, D.; Acheimastos, V.; Tasis, N.; Michalopoulos, N.; Kokoropoulos, P.; Papadoliopoulou, M.; Sotiropoulou, M.; Kapiris, S.; Metaxas, P.; Tsouknidas, I.; Kefili, D.; Petrakis, G.; Dakis, K.; Alexandridou, E.; Synekidou, E.; Dakis, K.; Papadopoulos, A.; Chouliaras, C.; Mouzakis, O.; Mulita, F.; Maroulis, I.; Vailas, M.; Triantafyllou, T.; Theodorou, D.; Lostoridis, E.; Nagorni, E.-.; Tourountzi, P.; Baili, E.; Charalabopoulos, A.; Liakakos, T.; Schizas, D.; Kozadinos, A.; Syllaios, A.; Machairas, N.; Kykalos, S.; Stamopoulos, P.; Delis, S.; Farazi-Chongouki, C.; Kalaitzakis, E.; Giannarakis, M.; Lasithiotakis, K.; Petra, G.; Gupta, A.; Medappil, N.; Muthukrishnan, V.; Kamar, J.; Lal, P.; Agarwal, R.; Magnoli, M.; Aonzo, P.; Serventi, A.; Giuliani, A.; Di Lascio, P.; Pinto, M.; Bergamini, C.; Bottari, A.; Fortuna, L.; Martellucci, J.; Cicako, A.; Miglietta, C.; Morino, M.; Delogu, D.; Picchetto, A.; Assenza, M.; D'Ambrosio, G.; Argenio, G.; Armellino, M.F.; Ioia, G.; Occhionorelli, S.; Andreotti, D.; Domenico, L.; Luppi, D.; Casadei, M.; Di Donato, L.; Manoochehri, F.; Lucia Marchese, T.R.; Sergi, W.; Manca, R.; Murgia, R.; Piras, E.; Conti, L.; Gianazza, S.; Rizzi, A.; Segalini, E.; Monti, M.; Iiritano, E.; Mariani, N.M.; De Nicola, E.; Scifo, G.; Pignata, G.; Andreuccetti, J.; Fleres, F.; Clarizia, G.; Spolini, A.; Biloslavo, A.; Germani, P.; Mastronardi, M.; Bogoni, S.; Palmisano, S.; De Manzini, N.; Marino, M.V.; Martines, G.; Trigiante, G.; Lagouvardou, E.; Anania, G.; Bombardini, C.; Oppici, D.; Pilia, T.; Murzi, V.; Gessa, E.; Bracale, U.; Di Nuzzo, M.M.; Peltrini, R.; Salvetti, F.; Vigano, J.; Sganga, G.; Bianchi, V.; Fransvea, P.; Fontana, T.; Sarro, G.; Dinuzzi, V.P.; Scaravilli, L.; Papa, M.V.; Jovine, E.; Ciabatti, G.; Mastrangelo, L.; Rottoli, M.; Ricci, C.; Russo, I.S.; Aiolfi, A.; Bona, D.; Lombardo, F.; Cianci, P.; Bini, R.; Chiara, O.; Cioffi, S.; Cantafio, S.; Coretti, G.; Licitra, E.; Savino, G.; Grimaldi, S.; Porfidia, R.; Moggia, E.; Garino, M.; Marafante, C.; Pesce, A.; Fabbri, N.; Feo, C.V.; Marra, E.; Troian, M.; Drigo, D.; Nagliati, C.; Andrea, M.; Danna, R.; Murgese, A.; Crespi, M.; Guerci, C.; Frontali, A.; Ferrari, L.; Favi,
- Anno di pubblicazione: 2022
- Tipologia: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/609343
Abstract
Background/objectives: Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines. Methods: All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study. Categorical data were reported as percentages representing the proportion of all study patients or different and well-defined cohorts for each variable. Continuous data were expressed as mean and standard deviation. Differences between the compliance obtained in the four different subgroups were compared using the Mann-Whitney U, Student's t, ANOVA or Kruskal-Wallis tests for continuous data, and the Chi-square test or the Fisher's exact test for categorical data. Results: Complete data were available for 5275 patients. The most commonly discordant gaps between daily clinical practice and recommendations included the optimal timing for the index CT scan (6.1%, χ2 6.71, P = 0.081), use of prophylactic antibiotics (44.2%, χ2 221.05, P < 0.00001), early enteral feeding (33.2%, χ2 11.51, P = 0.009), and the implementation of early cholecystectomy strategies (29%, χ2 354.64, P < 0.00001), with wide variability based on the admitting speciality. Conclusions: The results of this study showed an overall poor compliance with evidence-based guidelines in the management of ABP, with wide variability based on the admitting speciality. Study protocol registered in ClinicalTrials.Gov (ID Number NCT04747990).