Page 75 - Magyar Gasztroenterológiai Társaság 2020. november 6–7. – ONLINE KONGRESSZUS

Előadáskivonatok / Abstracts

Conclusion: We strongly highlight the need for adherence group (4.7% and 1.9%, p=0.045). Also, a tendency of more
to the guidelines during a diagnostic and etiological workup, severe and moderately severe cases was seen in the low
which could alter therapy. albumin group (p=0.056). From on-admission laboratory
parameters, patients had significantly lower eGFR and
106. EARLY RESULTS OF A PROSPECTIVE COHORT calcium and higher CRP values (p<0.001 in all cases). ROC
ANALYSIS- ASSOCIATION OF LOW ALBUMIN LEVELS analysis for mortality resulted in an AUC of 0.71 (95% CI:
AND MORTALITY IN ACUTE PANCREATITIS 0,619-0,801).
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Ocskay K. , Bajor J. , Gódi S. , Sarlós P. , Czakó L. , Izbéki Conclusion: The overall predictive value of albumin for
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F. , Hamvas J. , Papp M. , Varga M. , Török I. , Mickevicius mortality in our cohort was acceptable, but not as strong as
A. 11,12 , Sallinen V. , Ramirez Maldonado E. , Galeev S. , previously reported.
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Mikó A. , Erőss B. , Szakács Z. , Hegyi P. , Faluhelyi N. ,
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Farkas O. , Kanizsai P. , Miseta A. , Nagy T. , 107. THE IMPACT OF LIVER SUPPORT SYSTEMS ON
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Hágendorn R. , Márton Z. , Szentesi A. , Hegyi P. 1,4,5 , SURVIVAL IN ACUTE-ON-CHRONIC LIVER FAILURE: A
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Párniczky A. NETWORK META-ANALYSIS
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1. Institute for Translational Medicine, Medical School, Ocskay K. , Kanjo A. , Gede N. , Szakács Z. , Pár G. ,
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University of Pécs, Pécs, Hungary; 2. Heim Pál National Erőss B. , Péter H. 1,4,5 , Molnár Z.
Institute of Pediatrics, Budapest, Hungary; 3. Division of 1. Institute for Translational Medicine, Medical School,
Gastroenterology, First Department of Medicine, Medical University of Pécs, Pécs, Hungary; 2. Heim Pál National
School, University of Pécs, Pécs, Hungary; 4. Division of Institute of Pediatrics, Budapest, Hungary; 3. Division of
Translational Medicine, First Department of Medicine, Gastroenterology, First Department of Medicine, Medical
Medical School, University of Pécs, Pécs, Hungary; 5. First School, University of Pécs, Pécs, Hungary; 4. Division of
Department of Medicine, University of Szeged, Szeged, Translational Medicine, First Department of Medicine,
Hungary; 6. Szent György University Teaching Hospital of Medical School, University of Pécs, Pécs, Hungary; 5. First
Fejér County, Székesfehérvár, Hungary; 7. Bajcsy-Zsilinszky Department of Medicine, University of Szeged, Szeged,
Hospital, Budapest, Hungary; 8. Department of Internal Hungary
Medicine, Division of Gastroenterology, University of
Debrecen, Debrecen, Hungary; 9. Dr. Réthy Pál Hospital, Introduction: The role of artificial and bioartificial liver
Békéscsaba, Hungary; 10. County Emergency Clinical support systems (ALSS) in acute-on-chronic liver failure
Hospital - Gastroenterology and University of Medicine, (ACLF) is still controversial.
Pharmacy, Sciences and Technology, Targu Mures, Aims: Our aim was to perform a network meta-analysis
Romania; 11. Vilnius University Hospital Santaros Clinics, comparing different liver support systems and standard
Vilnius, Lithuania; 12. Clinics of Abdominal Surgery, medical therapy (SMT) in patients with ACLF.
Nephrourology and Gastroenterology, Faculty of Medicine, Methods: A Bayesian network meta-analysis of randomized
Vilnius University, Vilnius, Lithuania; 13. Department of controlled trials was conducted. Main outcomes were: 1- and
Transplantation and Liver Surgery, Helsinki University 3-month overall survival (OS) and 1- and 3-month transplant
Hospital and University of Helsinki, Helsinki, Finland; 14. free survival (TFS). The RoB2 tool and grade approach were
General Surgery, Consorci Sanitari del Garrof, Sant Pere de used for the assessment of risk of bias (ROB) and quality of
Ribes, Spain; 15. Saint Luke Clinical Hospital, St. evidence (QE).
Petersburg, Russia; 16. Department of Radiology, Medical Results: The systematic search yielded 2774 results. In the
School, University of Pécs, Pécs, Hungary; 17. Department quantitative synthesis 16 trials were included, using MARS®,
of Emergency Medicine, Medical School, University of Pécs, Prometheus®, ELAD®, plasma exchange (PE) and
Pécs, Hungary; 18. Department of Laboratory Medicine, BioLogicDT®. PE significantly improved 3-month OS
Medical School, University of Pécs, Pécs, Hungary; 19. First compared to SMT (RR 0.74, CI: 0.6-0.94) and ranked first on
Department of Medicine, Medical School, University of Pécs, the cumulative ranking curves in 3 outcomes. ELAD only
Pécs, Hungary suggested survival benefit at 1-month TFS, ranking first
before PE. Regarding other comparisons, MARS® seemed
Introduction: Acute pancreatitis (AP) is still associated with to perform better than ELAD®, Prometheus®, BioLogicDT®
significant morbidity and mortality worldwide. Thus, the early and SMT, but it did not reach statistical significance. Overall,
identification of high-risk patients is critical. studies with low RoB were rare and the QE is of low or very
Hypoalbuminemia was shown to be independently low grade.
associated with persistent organ failure and death in Conclusion: This is the first network meta-analysis
retrospective AP cohorts. evaluating the effect of all available and tested artificial and
Aims: Our aim was to validate the correlation between on- bioartificial liver support therapies on survival in ACLF.
admission serum albumin levels and clinical outcomes of AP Plasma exchange seemed to have the most beneficial effect
in a large prospective multicenter cohort. on survival in ACLF at present, but based on the high ROB
Methods: The Hungarian Pancreatic Study Group (HPSG) and low QE more and better designed trials are needed.
has prospectively enrolled patients with diagnosis of AP from
12 countries and 26 centers from 2012 to 2018. Patients 108. RECURRENT ACUTE PANCREATITIS PREVENTION
were divided into low and normal albumin groups, the cutoff BY THE ELIMINATION OF ALCOHOL AND CIGARETTE
being 35 g/L. We used Chi-square test, Mann-Whitney-U test SMOKING (REAPPEAR): PROTOCOL OF A
and receiver operating characteristic curve analysis. RANDOMIZED CONTROLLED TRIAL AND COHORT
Results: From the validated cases, 822 patients had on- STUDY
admission albumin levels. With 58% males, mean age of 55.7 Ocskay K. , Juhász M. , Farkas N. , Szakács Z. , Zemplényi
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years, 20% severe and 6% moderately severe cases, 2.6% A. , Erdősi D. , Párniczky A. , Hegyi P. 1,4,5
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mortality rate this cohort proved to be representative of the 1. Institute for Translational Medicine, Medical School,
general characteristics of the disease. Older age, alcoholic University of Pécs, Pécs, Hungary; 2. Chancellery, Health
etiology and more comorbidities were characteristic of the Technology Assessment Unit, University of Pécs, Pécs,
low albumin group. Mortality was significantly higher in this Hungary; 3. Heim Pál National Institute of Pediatrics,
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Central European Journal of Gastroenterology and Hepatology 73
Volume 6, Supplementum 2 / November 2020