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Home monitoring vs hospitalization for mild acute pancreatitis. A pilot randomized controlled clinical trials.
Sorribas, Maria; Carnaval, Thiago; Peláez, Núria; Secanella, Luis; Salord, Silvia; Sarret, Sònia; Videla, Sebastián; Busquets, Juli.
Afiliación
  • Sorribas M; Digestive and General Surgery Department, Bellvitge University Hospital, L'Hospitalet DE Llobregat, Barcelona, Spain.
  • Carnaval T; Research Group of Hepato-Biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, University of Barcelona, L'Hospitalet DE Llobregat, Barcelona, Spain.
  • Peláez N; Pharmacology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, IDIBELL, University of Barcelona, L'Hospitalet DE Llobregat, Barcelona, Spain.
  • Secanella L; Digestive and General Surgery Department, Bellvitge University Hospital, L'Hospitalet DE Llobregat, Barcelona, Spain.
  • Salord S; Research Group of Hepato-Biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, University of Barcelona, L'Hospitalet DE Llobregat, Barcelona, Spain.
  • Sarret S; Digestive and General Surgery Department, Bellvitge University Hospital, L'Hospitalet DE Llobregat, Barcelona, Spain.
  • Videla S; Research Group of Hepato-Biliary and Pancreatic Diseases, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, University of Barcelona, L'Hospitalet DE Llobregat, Barcelona, Spain.
  • Busquets J; Gastroenterology Department, Bellvitge University Hospital, L'Hospitalet DE Llobregat, Barcelona, Spain.
Medicine (Baltimore) ; 102(20): e33853, 2023 May 19.
Article en En | MEDLINE | ID: mdl-37335696
INTRODUCTION: Acute pancreatitis is a high-incidence benign disease. In 2009, it was the second highest cause of total hospital stays, the largest contributor to aggregate costs (approximately US$ 7000.00 per hospitalization), and the fifth leading cause of in-hospital deaths in the United States. Although almost 80% of acute pancreatitis cases are mild (usually requiring short-term hospitalization and without further complications), severe cases can be quite challenging.Classifications, scores, and radiological criteria have been developed to predict disease severity and outcome accurately; however, in-hospital care remains of widespread use, regardless of disease severity. A recent Turkish study reported that mild acute pancreatitis can be effectively and safely managed with home monitoring. Although the optimal timing for oral refeeding remains controversial and could cast some doubt on the feasibility of home monitoring, some guidelines already advocate for starting it within 24 hours.The present clinical trial aims to assess whether home monitoring is effective, safe and non-inferior to hospitalization for managing mild acute pancreatitis. METHODS: This will be a multicenter open-label randomized (1:1) controlled clinical trial to assess the efficacy and safety of home monitoring compared to in-hospital care for mild acute pancreatitis. All patients coming to the emergency department with suspected acute pancreatitis will be screened for enrollment. The main variable will be treatment failure (Yes/No) within the first 7 days after randomization. DISCUSSION: Acute pancreatitis implies a high economic burden in healthcare systems worldwide. Recent evidence suggests that mild disease can be safely and effectively treated with home monitoring. This approach may produce considerable cost savings and positively impact patients' quality of life. We expect the results to show that home monitoring is effective and not inferior to hospitalization for managing mild acute pancreatitis and that the economic costs are lower, kickstarting similar trials throughout the world, optimizing the use of limited healthcare budgets, and improving patients' quality of life.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pancreatitis / Calidad de Vida Tipo de estudio: Clinical_trials / Diagnostic_studies / Guideline / Prognostic_studies / Qualitative_research Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Medicine (Baltimore) Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pancreatitis / Calidad de Vida Tipo de estudio: Clinical_trials / Diagnostic_studies / Guideline / Prognostic_studies / Qualitative_research Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Medicine (Baltimore) Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos