Luiken, InaEisenmann, StephanGarbe, JakobSternby, HannaVerdonk, Robert C.Dimova, AlexandraIgnatavicius, PovilasIlzarbe Sánchez, LucasKoiva, PeeterPenttilä, Anne K.Regnér, SaraDober, JohannesWohlgemuth, Walter A.Brill, RichardMichl, PatrickRosendahl, JonasDamm, Marko2022-10-182022-10-182022Luiken I, Eisenmann S, Garbe J, Sternby H, Verdonk RC, Dimova A, Ignatavicius P, Ilzarbe L, Koiva P, Penttilä AK, Regnér S, Dober J, Wohlgemuth WA, Brill R, Michl P, Rosendahl J, Damm M. Pleuropulmonary pathologies in the early phase of acute pancreatitis correlate with disease severity. PLoS One. 2022 Feb 7;17(2):e0263739. DOI: 10.1371/journal.pone.02637391932-6203http://hdl.handle.net/10230/54441Background: Respiratory failure worsens the outcome of acute pancreatitis (AP) and underlying factors might be early detectable. Aims: To evaluate the prevalence and prognostic relevance of early pleuropulmonary pathologies and pre-existing chronic lung diseases (CLD) in AP patients. Methods: Multicentre retrospective cohort study. Caudal sections of the thorax derived from abdominal contrast enhanced computed tomography (CECT) performed in the early phase of AP were assessed. Independent predictors of severe AP were identified by binary logistic regression analysis. A one-year survival analysis using Kaplan-Meier curves and log rank test was performed. Results: 358 patients were analysed, finding pleuropulmonary pathologies in 81%. CECTs were performed with a median of 2 days (IQR 1-3) after admission. Multivariable analysis identified moderate to severe or bilateral pleural effusions (PEs) (OR = 4.16, 95%CI 2.05-8.45, p<0.001) and pre-existing CLD (OR = 2.93, 95%CI 1.17-7.32, p = 0.022) as independent predictors of severe AP. Log rank test showed a significantly worse one-year survival in patients with bilateral compared to unilateral PEs in a subgroup. Conclusions: Increasing awareness of the prognostic impact of large and bilateral PEs and pre-existing CLD could facilitate the identification of patients at high risk for severe AP in the early phase and thus improve their prognosis.application/pdfeng© 2022 Luiken et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.info:eu-repo/semantics/articlehttp://dx.doi.org/10.1371/journal.pone.0263739PancreatitisPleural effusionPleuraeRespiratory failureThoraxDeath ratesMedical risk factorsThoracic diaphragminfo:eu-repo/semantics/openAccess