Katuchova Jana, Bober Juraj, Harbulak Pavol, Hudak Alexander, Gajdzik Tomas, Kalanin Rastislav, Radonak Jozef
First Department of Surgery, University Hospital Košice, Tr. SNP 1, 040 11, Košice, Slovakia,
Wien Klin Wochenschr. 2014 Apr;126(7-8):223-7. doi: 10.1007/s00508-014-0507-7. Epub 2014 Feb 13.
Obesity plays an important role in increasing the risks of cardiovascular diseases, metabolic diseases, and death. Controversy persists concerning the degrees to which obesity influences mortality and morbidity in severe acute pancreatitis.
Between 2008 and 2012, the findings of 384 consecutive acute pancreatitis patients were analyzed in a prospective trial. Ranson's scores, Acute Physiology And Chronic Evaluation II scores, and computed tomography severity indexes were calculated. Patients were categorized by body mass index (BMI) and waist circumference for the analysis. The aim of this study was to investigate the influence of obesity on local and systemic complications as well as on mortality in severe acute pancreatitis patients.
Severe acute pancreatitis was confirmed in 91 (23.7 %) patients. Local and systemic complications were recorded in 64 (16.7 %) and 51 (13.3 %) patients, respectively. Obesity calculated by BMI was identified as a significant risk factor for local and systemic complications (p < 0.02 and p < 0.03, respectively). Moreover, in this study, obesity was also categorized by waist circumference and was confirmed as a risk factor (p < 0.01). The overall mortality rate was 2.4 %, i.e., nine patients died. This study indicates that obesity can have a statistically significant influence on the mortality of severe acute pancreatitis patients.
The presence of obesity has a negative impact on the survival rate of severe acute pancreatitis patients. Obese patients have higher incidence of local and systemic complications. Obesity seems to be a negative prognostic factor in severe acute pancreatitis patients.
肥胖在增加心血管疾病、代谢性疾病和死亡风险方面起着重要作用。关于肥胖在重症急性胰腺炎中影响死亡率和发病率的程度，争议仍然存在。
在2008年至2012年期间，对一项前瞻性试验中384例连续急性胰腺炎患者的研究结果进行了分析。计算了兰森评分、急性生理与慢性健康状况评分系统II评分以及计算机断层扫描严重程度指数。根据体重指数（BMI）和腰围对患者进行分类以进行分析。本研究的目的是调查肥胖对重症急性胰腺炎患者局部和全身并发症以及死亡率的影响。
91例（23.7%）患者被确诊为重症急性胰腺炎。分别有64例（16.7%）和51例（13.3%）患者出现局部和全身并发症。通过BMI计算得出的肥胖被确定为局部和全身并发症的重要危险因素（分别为p < 0.02和p < 0.03）。此外，在本研究中，肥胖也根据腰围进行分类，并被确认为危险因素（p < 0.01）。总死亡率为2.4%，即9例患者死亡。本研究表明，肥胖对重症急性胰腺炎患者的死亡率有统计学上的显著影响。
肥胖的存在对重症急性胰腺炎患者的生存率有负面影响。肥胖患者局部和全身并发症的发生率更高。肥胖似乎是重症急性胰腺炎患者的一个不良预后因素。
