Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University.
Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu.
Eur J Gastroenterol Hepatol. 2020 Aug;32(8):963-970. doi: 10.1097/MEG.0000000000001753.
Acute pancreatitis is one of the most common causes of inpatient care among gastrointestinal conditions. Few easy and commodious biomarkers are used in clinical practice to predict the prognosis of patients with acute pancreatitis. This study was aimed at examining the association of albumin-bilirubin (ALBI) score and in-hospital mortality in critically ill patients with acute pancreatitis.
We enrolled all critically ill patients with acute pancreatitis retrospectively in Monitoring in Intensive Care Database III database. Clinical data and demographic information were collected for each patient in our study. Multivariate logistic regression models and smooth curve fitting were used to determine whether ALBI score could be an independent indicator for the prognosis of patients with acute pancreatitis. Predictive performance of ALBI was assessed by receiver operating characteristic analysis.
A total of 284 patients with acute pancreatitis met the inclusion criteria, and 35 patients died in hospital. The ALBI in nonsurvived group was much higher than survived group (-1.0 vs. -1.5; P < 0.001). The association of ALBI and in-hospital mortality was almost linear by smooth curve fitting (P < 0.001) and positive associations were observed between ALBI and RDW and WBC in patients with acute pancreatitis. Multivariate logistic regression indicated ALBI could be independent risk factors to predict the prognosis of patients with acute pancreatitis (odds ratios = 1.60; P = 0.02). The area under curve of in-hospital mortality prediction (0.86; P < 0.001) were superior to Sequential Organ Failure Assessment (SOFA) score (0.72; P < 0.001), Simplified Acute Physiology Score II (SAPS-II) (0.71; P < 0.001), Acute Physiology and Chronic Health Evaluation II (APACHE-II, 0.83; P < 0.001), Ranson score (0.75; P < 0.001) and Glasgow score (0.72; P < 0.001).
ALBI could be a useful marker of in-hospital mortality for patients with acute pancreatitis, which was better than SOFA, SAPS-II, APACHE-II, Ranson score and Glasgow score in our study.
急性胰腺炎是胃肠道疾病中导致住院治疗的最常见原因之一。目前在临床实践中，很少有简单且便利的生物标志物用于预测急性胰腺炎患者的预后。本研究旨在探讨白蛋白-胆红素（ALBI）评分与重症急性胰腺炎患者院内死亡率的关系。
我们回顾性地从监测重症监护数据库 III 数据库中纳入所有重症急性胰腺炎患者。本研究收集了每位患者的临床数据和人口统计学信息。多变量逻辑回归模型和光滑曲线拟合用于确定 ALBI 评分是否可以作为急性胰腺炎患者预后的独立指标。通过接受者操作特征分析评估 ALBI 的预测性能。
共纳入 284 例急性胰腺炎患者，其中 35 例患者院内死亡。死亡组的 ALBI 明显高于存活组（-1.0 比-1.5；P<0.001）。通过光滑曲线拟合，ALBI 与院内死亡率之间的关系几乎呈线性（P<0.001），并且在急性胰腺炎患者中，ALBI 与红细胞分布宽度和白细胞计数呈正相关。多变量逻辑回归表明，ALBI 是预测急性胰腺炎患者预后的独立危险因素（比值比=1.60；P=0.02）。预测院内死亡率的曲线下面积（0.86；P<0.001）优于序贯器官衰竭评估（SOFA）评分（0.72；P<0.001）、简化急性生理学评分 II（SAPS-II）（0.71；P<0.001）、急性生理学和慢性健康评估 II（APACHE-II）评分（0.83；P<0.001）、Ranson 评分（0.75；P<0.001）和格拉斯哥评分（0.72；P<0.001）。
ALBI 可以作为急性胰腺炎患者院内死亡率的有用标志物，在本研究中，其优于 SOFA、SAPS-II、APACHE-II、Ranson 评分和格拉斯哥评分。
