Analysis of factors influencing onset and survival of patients with severe acute pancreatitis: A clinical study

医学 急性胰腺炎 置信区间 内科学 优势比 接收机工作特性 胃肠病学 重症监护室 逻辑回归 曲线下面积 C反应蛋白 胰腺炎 D-二聚体 外科 炎症
作者
Xiaoli Qin,Shili Xiang,W Li
出处
期刊:Immunity, inflammation and disease [Wiley]
卷期号:12 (6)
标识
DOI:10.1002/iid3.1267
摘要

Abstract Objectives Acute pancreatitis (AP) is an inflammatory disease of the pancreas, and the prognosis of severe AP (SAP) is poor. The study aimed to identify promising biomarkers for predicting the occurrence and survival outcome of SAP patients. Materials and Methods Two hundred and forty AP patients were retrospectively recruited, in which 72 cases with SAP. Blood test was done for collection of laboratory indicators. After treatment, the mortality of patients was recorded. Results Patients in the SAP group had higher intensive care unit admissions and longer hospital stays ( p < .001). Among laboratory parameters, significantly high values of C‐reactive protein (CRP), triglycerides and glucose (TyG) index, Von willebrand factor antigen (vWF:Ag) and D‐dimer were found in SAP groups relative to non‐SAP ones. Receiver operating characteristic curve indicated the good performance of CRP, TyG index, vWF:Ag and D‐dimer in SAP diagnosis. Among all SAP cases, 51 survived while 21 died. TyG index (odds ratio [OR] = 6.914, 95% confidence interval [CI] = 1.193–40.068, p = .028), vWF:Ag (OR = 7.441, 95% CI = 1.236–244.815, p = .028), and D‐dimer (OR = 7.987, 95% CI = 1.251–50.997, p = .028) were significantly related to survival outcome of SAP patients by multiple logistic regression analysis. Both TyG index and vWF showed favorable efficiency in predicting overall prognosis. The area under the curve for the multivariate model (PRE = −35.908 + 2.764 × TyG + 0.021 × vWF:Ag) was 0.909 which was greater than 0.9, indicating its excellent performance in prognosis prediction. Conclusion CRP, TyG index, vWF:Ag, and D‐dimer values on admission may be potential clinical predictors of the development of SAP. Moreover, TyG index and vWF:Ag may be helpful to predict survival outcome.
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