严重急性胰腺炎的短期和长期生存：来自单个中心的回顾性 17 年队列研究。
Short- and long-term survival after severe acute pancreatitis: A retrospective 17 years' cohort study from a single center.
机构信息
Department of Abdominal Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Abdominal Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
出版信息
J Crit Care. 2019 Oct;53:81-86. doi: 10.1016/j.jcrc.2019.06.001. Epub 2019 Jun 4.
PURPOSE
To study mortality in severe acute pancreatitis (SAP) and to identify risk factors for mortality.
MATERIALS AND METHODS
A retrospective 17-years' cohort study of 435 consecutive adult patients with SAP treated at intensive care unit of a university hospital.
RESULTS
Overall, 357 (82.1%) patients survived at 90 days follow-up. Three-hundred six (89.5%) patients under 60 years, 38 (60.3%) patients between 60 and 69 years, and 13 (43.3%) patients over 69 years of age survived at 90 days follow-up. Independent risk factors for death within 90-days were: 60 to 69 years of age (odds ratio [OR] 5.1), >69 years of age (OR 10.4), female sex (OR 2.0), heart disease (OR 2.9), chronic liver failure (OR 12.3), open abdomen treatment (OR 4.4) and sterile necrosectomy within 4 weeks (OR 14.7). The 10-year survival estimate was <70% in patients under 60 years and <30% in patients over 60 years. Underlying cause of death after the initial 90-day follow-up period was alcohol-related in 48 (57.1%) patients, and all of them had suffered from alcoholic SAP.
CONCLUSIONS
Although younger patients have excellent short-term survival after SAP, the long-term survival estimate is disappointing mostly due to alcohol abuse.
目的
研究重症急性胰腺炎（SAP）的死亡率，并确定死亡的危险因素。
材料和方法
对一家大学医院重症监护病房收治的 435 例连续成年 SAP 患者进行了 17 年的回顾性队列研究。
结果
总体而言，357 例（82.1%）患者在 90 天随访时存活。306 例（89.5%）年龄小于 60 岁，38 例（60.3%）年龄在 60 至 69 岁之间，13 例（43.3%）年龄大于 69 岁的患者在 90 天随访时存活。90 天内死亡的独立危险因素为：60-69 岁（比值比[OR] 5.1），69 岁以上（OR 10.4），女性（OR 2.0），心脏病（OR 2.9），慢性肝功能衰竭（OR 12.3），开放性腹部治疗（OR 4.4）和 4 周内无菌性坏死性切除术（OR 14.7）。60 岁以下患者的 10 年生存率估计值<70%，60 岁以上患者的生存率估计值<30%。在最初 90 天随访期后，死亡的根本原因是酒精相关，其中 48 例（57.1%）患者患有酒精性 SAP。
结论
尽管年轻患者 SAP 后短期生存率良好，但长期生存率估计令人失望，主要是由于酗酒。
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