Department of Gastroenterology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
Aging Clin Exp Res. 2021 Jan;33(1):183-192. doi: 10.1007/s40520-020-01523-1. Epub 2020 Mar 17.
Moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) are associated with organ failure (OF), which can be lethal.
This study determined the factors that predict the severity of AP at admission in elderly patients.
In this retrospective study, the data from elderly patients (> 60 years of age) admitted within 72 h of onset of symptoms without OF were collected. These data at admission were analyzed and correlated with the severity of AP. To identify the factors associated with more serious AP (i.e. MSAP and SAP), patients were divided into mild acute pancreatitis (MAP) and MSAP + SAP groups.
A total of 198 patients [MAP group (n = 135) and MSAP + SAP group (n = 63)] were included. Biliary disease was the most common etiology. Respiratory failure was the most common OF. Logistic regression analyses indicated that idiopathic etiology (odds ratio [OR]: 3.029, 95% confidence interval [CI]: 1.017-9.022, p = 0.047), pre-existing pulmonary disease (OR: 7.104, CI 1.750-28.84, p = 0.006), increased hematocrit level (OR: 3.717, 95%CI 1.372-10.070, p = 0.010), serum calcium (OR: 0.023, 95%CI 0.001-0.371, p = 0.008), serum glucose (OR: 1.157, 95%CI 1.031-1.299, p = 0.013), arterial partial pressure of oxygen (PaO) (OR: 0.914, 95%CI 0.874-0.956, p < 0.001), and pleural effusion (OR: 4.979, 95%CI 1.863-13.303, p = 0.001) were independent predictors of more serious AP.
This study found that idiopathic etiology, pre-existing pulmonary diseases, increased hematocrit level or pleural effusion, higher serum glucose, and lower serum calcium or PaO at the time of admission independently correlated with more serious AP in the elderly patients.
中度重症急性胰腺炎（MSAP）和重症急性胰腺炎（SAP）与器官衰竭（OF）有关，OF 可能致命。
本研究旨在确定预测老年患者入院时 AP 严重程度的因素。
在这项回顾性研究中，收集了在症状发作后 72 小时内无 OF 入院的老年患者（>60 岁）的数据。对这些入院时的数据进行分析，并与 AP 的严重程度相关联。为了确定与更严重的 AP（即 MSAP 和 SAP）相关的因素，将患者分为轻度急性胰腺炎（MAP）和 MSAP+SAP 组。
共纳入 198 例患者[MAP 组（n=135）和 MSAP+SAP 组（n=63）]。胆源性疾病是最常见的病因。呼吸衰竭是最常见的 OF。逻辑回归分析表明，特发性病因（比值比[OR]：3.029，95%置信区间[CI]：1.017-9.022，p=0.047）、预先存在的肺部疾病（OR：7.104，CI 1.750-28.84，p=0.006）、红细胞压积水平升高（OR：3.717，95%CI 1.372-10.070，p=0.010）、血清钙（OR：0.023，95%CI 0.001-0.371，p=0.008）、血清葡萄糖（OR：1.157，95%CI 1.031-1.299，p=0.013）、动脉血氧分压（PaO）（OR：0.914，95%CI 0.874-0.956，p<0.001）和胸腔积液（OR：4.979，95%CI 1.863-13.303，p=0.001）是更严重 AP 的独立预测因素。
本研究发现，特发性病因、预先存在的肺部疾病、红细胞压积升高或胸腔积液、较高的血清葡萄糖和较低的血清钙或 PaO 与老年患者入院时更严重的 AP 独立相关。
