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Early use of low-molecular-weight heparin reduces mortality and complications in moderate to severe cases of acute pancreatitis.
A systematic review and meta-analysis revealed that the administration of low molecular weight heparin [LMWH]) was associated with a significant reduction in mortality, multiple organ failure, and the requirement for endoscopic or surgical interventions in cases of acute pancreatitis. The objective of the study was to assess the effectiveness and safety of incorporating anticoagulant therapy into the management of acute pancreatitis.
The systematic search encompassed three databases without imposing restrictions. Eligible studies comprised observational studies and randomized controlled trials (RCTs) that reported variations in outcomes for acute pancreatitis sufferers who received anticoagulants (intervention group) along with standard of care (SOC), in comparison with individuals managed solely with SOC (control group).
Utilizing a random-effects model, mean differences (MD) and pooled odds ratios (OR) were calculated, along with their corresponding 95% confidence intervals (CI). Subgroup analyses were conducted based on disease severity and study design, among other criteria. Overall, 8 records were incorporated in the meta-analysis out of 8,223 records screened. With the exception of one, all the studies focused on LMWH.
Both observational studies and RCTs consistently reported favorable outcomes for the LMWH group. In the intervention group, there was a significant decline in the multiple organ failure [OR 0.32] and odds of mortality [OR 0.24] in the subgroup analysis of RCTs. Additionally, the use of LMWH considerably minimized the need for surgical or endoscopic interventions [OR 0.41].
Comparable results were witnessed in the subgroup analyses for severe and moderate cases. Unfortunately, due to limited data, subgroup analysis for mild cases could not be performed. The early initiation of LMWH therapy following the diagnosis of acute pancreatitis illustrated a notable reduction in major complication rates, thereby contributing to an improved overall prognosis in moderate and severe cases.
Frontiers in Medicine (Lausanne)
Low molecular weight heparin decreases mortality and major complication rates in moderately severe and severe acute pancreatitis–a systematic review and meta-analysis
Cristina Patoni et al.
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