中度重症急性胰腺炎：这种新的急性胰腺炎亚组的前瞻性验证。

Moderately severe acute pancreatitis: prospective validation of this new subgroup of acute pancreatitis.

机构信息

Mayo Clinic College of Medicine, Rochester, MN, USA.

出版信息

Pancreas. 2012 Mar;41(2):306-9. doi: 10.1097/MPA.0b013e318229794e.

DOI:10.1097/MPA.0b013e318229794e

PMID:22015971

Abstract

OBJECTIVE

We described the entity moderately severe acute pancreatitis (MSAP), characterized by local complications (LCs) without organ failure (OF). The aim of this study was to validate MSAP.

METHODS

We classified a prospectively collected cohort of 137 acute pancreatitis patients admitted to Mayo Clinic Hospitals into (a) severe acute pancreatitis (SAP; n = 15), presence of OF with/without LCs; (b) MSAP (n = 27), presence of LCs without OF; and (c) mild acute pancreatitis (MAP; n = 95), no OF and LCs. Primary outcomes were need for intensive care unit (ICU) care, total ICU days, total hospital stay, need for interventions, and death.

RESULTS

Scores in the Acute Physiology and Chronic Health Evaluation II during admission were significantly different among the 3 groups (MAP vs MSAP, P = 0.02; MSAP vs SAP, P = 0.001); scores in the systemic inflammatory response syndrome during admission were similar between MAP and MSAP. Compared with patients with MAP, patients with MSAP had a significantly longer hospital stay (4 [3.0-7.0] vs 6 [4.0-18.0] days). Compared with those with SAP, a significantly smaller proportion of patients with MSAP required ICU care (12% vs 80%); total hospital stay and need for interventions were similar (6 [4.0-18.0] vs 21 [11.8-27] days and 44% vs 33%, respectively). None of the MSAP patients died compared with 40% from the SAP group.

CONCLUSIONS

We have validated MSAP as an exclusive entity.

摘要

目的

我们描述了实体中度重症急性胰腺炎（MSAP），其特征为局部并发症（LCs）而无器官衰竭（OF）。本研究旨在验证 MSAP。

方法

我们将前瞻性收集的 Mayo 诊所医院收治的 137 例急性胰腺炎患者分为（a）重症急性胰腺炎（SAP；n = 15），存在 OF 伴/不伴 LCs；（b）MSAP（n = 27），存在 LCs 而无 OF；和（c）轻症急性胰腺炎（MAP；n = 95），无 OF 和 LCs。主要结局是需要重症监护病房（ICU）护理、ICU 总天数、总住院时间、需要干预和死亡。

结果

入院时急性生理学和慢性健康评估 II 评分在 3 组之间差异显著（MAP 与 MSAP，P = 0.02；MSAP 与 SAP，P = 0.001）；入院时全身炎症反应综合征评分在 MAP 和 MSAP 之间相似。与 MAP 患者相比，MSAP 患者的住院时间明显更长（4[3.0-7.0]与 6[4.0-18.0]天）。与 SAP 患者相比，MSAP 患者需要 ICU 护理的比例明显较小（12% vs 80%）；总住院时间和需要干预的情况相似（6[4.0-18.0]与 21[11.8-27]天和 44% vs 33%）。与 SAP 组的 40%相比，MSAP 组没有患者死亡。