coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis): The MANCTRA-1 international audit.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Podda Mauro, Pacella Daniela, Pellino Gianluca, Coccolini Federico, Giordano Alessio, Di Saverio Salomone, Pata Francesco, Ielpo Benedetto, Virdis Francesco, Damaskos Dimitrios, De Simone Belinda, Agresta Ferdinando, Sartelli Massimo, Leppaniemi Ari, Riboni Cristiana, Agnoletti Vanni, Mole Damian, Kluger Yoram, Catena Fausto, Pisanu Adolfo, MANCTRA-1 Collaborative Group, Principal Investigator, Steering Committee, MANCTRA-1 Coordinating Group, Local Collaborators, Argentina, Australia, Bahrain, Brazil, Bulgaria, China, Colombia, Czech Republic, Egypt, France, Georgia, Greece, Guatemala, India, Italy, Jordan, Malaysia, Mexico, Nigeria, Pakistan, Paraguay, Peru, Philippines, Poland, Portugal, Qatar, Romania, Russia, Serbia, Slovak Republic, South Africa, Spain, Sudan, Switzerland, Syria, Tunisia, Turkey, United Kingdom, Uruguay, Yemen
Аннотация
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).