Influence of patient factors on target plasma volume treated attainment rate during double filtration plasmapheresis in patients with hypertriglyceridemic acute pancreatitis.

Abstract

Introduction: This study aims to investigate patient factors affecting the rate of plasma volume target attained in hypertriglyceridemic pancreatitis (HTG-AP) patients undergoing double filtration plasmapheresis (DFPP).

Methods: A retrospective analysis of 82 HTG-AP-interpreted patients from January 2019 to April 2024 compared target plasma volume treated between up-to-scratch and non-scratch groups. The group comparison used independent samples t-test, Mann-Whitney U-test, and chi-square test. Binary logistic regression was used to identify independent risk factors for patients' plasma volume target failure. The ROC curve assessed these risk factors' diagnostic efficacy.

Results: Of 82 patients, 52 were classified as belonging to the up-to-scratch group, while the remaining 30 were classified as belonging to the non-to-scratch group. Statistically significant differences were seen between the groups regarding admission heart rate, triglyceride, calcitonin gene, C-reactive protein, D-dimer, and fibrinogen (FIB) levels (p <0.05). The binary logistic regression analysis showed that for every 1 mmol/L increase in triglycerides (TG), the probability of experiencing substandard target plasma handling increased by 5.0% (OR = 1.05, 95%CI 1.01-1.08, p = 0.009). Furthermore, for each g/L rise in FIB, there was a 74% increase in the likelihood of encountering suboptimal target plasma handling (OR = 1.74, 95%CI 1.18-2.56, p = 0.005). The ROC curve study revealed that the AUC for TG was 0.67, for FIB was 0.77, and for the combination of both markers was 0.80; all the p values were below 0.05.

Conclusion: The increased levels of TG and FIB are independent risk factors affecting the target plasma handling achievement rate in HTG-AP patients undergoing DFPP.