Prediction of Admission to Intensive Care Unit and 1-Year Mortality After Acute Pancreatitis With Walled-Off Pancreatic Necrosis: A Retrospective, Single-Center Cohort Study.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-05-01 Epub Date: 2024-02-26 DOI:10.1097/MPA.0000000000002314

Mohamed Ebrahim, Mikkel Parsberg Werge, Srdan Novovic, Nadia Emad Lotfi Amin, John Gásdal Karstensen, Henrik Løvendahl Jørgensen

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引用次数: 0

Abstract

Background and aims: Pancreatic walled-off necrosis (WON) carries significant mortality and morbidity risks, often necessitating intensive care unit (ICU) admission. This retrospective study aimed to evaluate whether routine biochemical parameters at the time of the index endoscopic procedure could predict ICU admission and 1-year mortality following endoscopic treatment of WON.

Materials and methods: We retrospectively identified 201 consecutive patients who underwent endoscopic drainage for WON between January 1, 2010, and December 31, 2020. Associations between routine biochemical blood tests and outcomes were assessed using logistic regression models.

Results: Within 1 year of the index endoscopy, 31 patients (15.4%) died, and 40 (19.9%) were admitted to the ICU due to sepsis. Preoperative electrolyte disturbances were more prevalent among ICU-admitted patients and nonsurvivors. Hyperkalemia, hypoalbuminemia, and elevated urea were significant predictors of 1-year mortality, while hypernatremia, elevated serum creatinine, and hypoalbuminemia predicted ICU admission. Predictive models exhibited good discriminative ability, with an AUC of 0.84 (95% CI,0,75-0.93) for 1-year mortality and 0.86 (95%CI, 0.79-0.92) for ICU admission.

Conclusions: Preoperative imbalances in routine blood tests effectively predict adverse outcomes in endoscopically treated WON patients.

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预测急性胰腺炎并发胰腺壁脱落坏死后入住重症监护病房和 1 年死亡率：一项回顾性单中心队列研究。

背景和目的：胰腺壁脱落坏死（WON）具有显著的死亡率和发病率风险，通常需要入住重症监护病房（ICU）。这项回顾性研究旨在评估内镜手术时的常规生化指标是否能预测内镜治疗胰壁脱落坏死后入住重症监护病房和 1 年的死亡率：我们回顾性地确定了 2010 年 1 月 1 日至 2020 年 12 月 31 日期间接受内镜引流治疗的 201 例连续患者。使用逻辑回归模型评估了常规血液生化检验与结果之间的关联：在接受内镜检查后的一年内，有31名患者（15.4%）死亡，40名患者（19.9%）因脓毒症住进了重症监护室。术前电解质紊乱在入住重症监护室的患者和非存活患者中更为普遍。高钾血症、低白蛋白血症和尿素升高是1年死亡率的重要预测因素，而高钠血症、血清肌酐升高和低白蛋白血症则是入住重症监护室的预测因素。预测模型具有良好的鉴别能力，1年死亡率的AUC为0.84（95% CI，0.75-0.93），入住ICU的AUC为0.86（95%CI，0.79-0.92）：结论：术前血常规检查失衡可有效预测接受内镜治疗的WON患者的不良预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.