Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy.
Can J Gastroenterol Hepatol. 2017;2017:5297143. doi: 10.1155/2017/5297143. Epub 2017 Sep 24.
To investigate the association between serum albumin levels within 24 hrs of patient admission and the development of persistent organ failure in acute pancreatitis.
A total of 700 patients with acute pancreatitis were enrolled. Multivariate logistic regression and subgroup analysis determined whether decreased albumin was independently associated with persistent organ failure and mortality. The diagnostic performance of serum albumin was evaluated by the area under Receiver Operating Characteristic (ROC) curves.
As levels of serum albumin decrease, the risk of persistent organ failure significantly increases ( < 0.001). The incidence of organ failure was 3.5%, 10.6%, and 41.6% in patients with normal albumin and mild and severe hypoalbuminaemia, respectively. Decreased albumin levels were also proportionally associated with prolonged hospital stay ( < 0.001) and the risk of death ( < 0.001). Multivariate analysis suggested that biliary etiology, chronic concomitant diseases, hematocrit, blood urea nitrogen, and the serum albumin level were independently associated with persistent organ failure. Blood urea nitrogen and the serum albumin level were also independently associated with mortality. The area under ROC curves of albumin for predicting organ failure and mortality were 0.78 and 0.87, respectively.
A low serum albumin is independently associated with an increased risk of developing of persistent organ failure and death in acute pancreatitis. It may also be useful for the prediction of the severity of acute pancreatitis.
本研究旨在探讨入院 24 小时内血清白蛋白水平与急性胰腺炎持续性器官衰竭发展之间的关系。
共纳入 700 例急性胰腺炎患者。采用多变量逻辑回归和亚组分析确定白蛋白降低是否与持续性器官衰竭和死亡率独立相关。通过接受者操作特征（ROC）曲线下面积评估血清白蛋白的诊断性能。
随着血清白蛋白水平的降低，持续性器官衰竭的风险显著增加（<0.001）。正常白蛋白、轻度和重度低蛋白血症患者的器官衰竭发生率分别为 3.5%、10.6%和 41.6%。白蛋白水平降低也与住院时间延长（<0.001）和死亡风险（<0.001）呈比例相关。多变量分析表明，胆源性病因、慢性合并症、红细胞压积、血尿素氮和血清白蛋白水平与持续性器官衰竭独立相关。血尿素氮和血清白蛋白水平也与死亡率独立相关。白蛋白预测器官衰竭和死亡率的 ROC 曲线下面积分别为 0.78 和 0.87。
低血清白蛋白与急性胰腺炎持续性器官衰竭和死亡风险增加独立相关。它也可能有助于预测急性胰腺炎的严重程度。
