Evidence map›Paper›PMID 42489684›Full record

ArticleJournal of gastroenterology2026

Association of early crystalloid type with mortality and costs in acute pancreatitis: a nationwide cohort study.

Haruka Okada, Masayasu Horibe, Yusuke Sasabuchi, Fateh Bazerbachi, Tsubasa Sato, Yuichiro Matsuo, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Takanori Kanai

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In one paragraph

Article in Journal of gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Haruka OkadaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Masayasu HoribeDivision of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan. masayasu.horibe@gmail.com.
Yusuke SasabuchiDepartment of Real-world Evidence, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Fateh BazerbachiCentraCare, Interventional Endoscopy Program, St. Cloud Hospital, St. Cloud, MN, USA.
Tsubasa SatoDivision of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Yuichiro MatsuoDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Hiroki MatsuiDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Kiyohide FushimiDepartment of Health Policy and Informatics, Institute of Science Tokyo Graduate School, Tokyo, Japan.
Hideo YasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Takanori KanaiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan. takagast@keio.jp.

Funding

Ministry of Health, Labour and Welfare 23AA2003Ministry of Health, Labour and Welfare 24AA2006
6 · The paper itself

Abstract

backgroundEarly intravenous crystalloid resuscitation is central to acute pancreatitis (AP) management; however, whether normal saline (NS) or balanced Ringer's solutions (RS) are superior for reducing mortality remains unsettled.

methodsUsing the Japanese Diagnosis Procedure Combination database (July 2010-March 2022), we identified adults admitted to general medical wards with AP who had a hospital stay longer than 3 days and received sufficient fluid resuscitation within three days of admission. Patients were classified by predominant crystalloid exposure during the first three days (NS vs. RS). Propensity score matching was used to balance measured confounders and compare in-hospital mortality and total hospitalization costs between the two groups.

resultsAmong 43,247 eligible patients, 1,652 (4.0%) predominantly received NS and 41,595 (96.0%) predominantly received RS. Propensity score matching yielded 1,650 well-balanced pairs. In-hospital mortality was higher with NS than with RS (2.9% vs 1.8%; risk difference, 1.2%; 95% CI, 0.12% to 2.2%). NS was also associated with higher total hospitalization costs (difference, 1,344 USD; 95% CI, 725 to 1,963).

conclusionsIn this nationwide cohort of adults with AP admitted to general medical wards, predominant early use of NS was associated with higher in-hospital mortality and higher hospitalization costs compared with RS.

Indexed as

Acute pancreatitisMortalityNationwide databaseNormal salineRinger’s solutions

Identifiers

PMID42489684

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.