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The Utility of the Systemic Inflammatory Respsonse Syndrome Score on Admission in Children With Acute Pancreatitis
Amit S Grover1, Vivek Kadiyala, Peter A Banks
1From the *Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA; †Division of Gastroenterology, Center for Pancreatic Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; ‡Division of Gastroenterology, Hepatology and Nutrition, Ohio State University, Columbus, OH; and §Department of Gastroenterology, Hepatology and Nutrition, University of Massachusetts Memorial Children's Medical Center, Boston, MA.
Insights
Systemic inflammatory response syndrome (SIRS) in pediatric patients with acute pancreatitis (AP) at admission predicts longer hospital stays and ICU admission. Early identification of SIRS is crucial for managing AP in children.
Area of Science:
- Pediatric Gastroenterology
- Critical Care Medicine
- Inflammatory Diseases
Background:
- Pediatric acute pancreatitis (AP) can present with systemic inflammatory response syndrome (SIRS) criteria upon admission.
- In adults with AP, early SIRS is linked to severe disease outcomes.
Purpose of the Study:
- To assess the significance of SIRS in pediatric AP patients regarding clinical outcomes.
- To determine if SIRS at admission predicts disease severity in children with AP.
Main Methods:
- Retrospective cohort study of pediatric AP admissions at Boston Children's Hospital (2010).
- Primary outcomes: increased length of stay (LOS) and intensive care unit (ICU) admission.
- Analysis included SIRS presence, demographics, and clinical data at admission.
Main Results:
- Of 50 pediatric AP cases, 22 (44%) had SIRS at admission.
- SIRS at admission independently predicted increased LOS (OR 7.99, P=0.045).
- SIRS at admission also predicted ICU admission (OR 12.06, P=0.027).
Conclusions:
- SIRS criteria at admission are a valuable predictor for pediatric AP.
- Early identification of SIRS can forecast longer hospital stays and ICU needs in children with AP.
Objectives:
Pediatric patients with acute pancreatitis (AP) may meet criteria at admission for the systemic inflammatory response syndrome (SIRS). Early SIRS in adults with AP is associated with severe disease. Our aim was to evaluate the importance of SIRS in children presenting with AP on various outcomes.
Methods:
This is a retrospective cohort study of children hospitalized with AP at Boston Children's Hospital in 2010. Increased length of stay (LOS) and/or admission to the intensive care unit (ICU) served as the primary outcomes. Statistical analyses of measures studied included the presence of SIRS, demographic, and clinical information present on admission.
Results:
Fifty encounters, in which AP was the primary admitting diagnosis, were documented. Patients had a median LOS of 4.5 (interquartile range, 2-9) days. Systemic inflammatory response syndrome was present in 22 (44%) of 50 patients at admission. Systemic inflammatory response syndrome at admission was an independent predictor of increased LOS (odds ratio, 7.99; P = 0.045) as well as admission to the ICU (odds ratio, 12.06; P = 0.027).
Conclusions:
The presence of SIRS criteria on admission serves as a useful and easy-to-calculate predictor of increased LOS and admission to ICU in children with AP.
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