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坏死性胰腺炎的器官衰竭和死亡的临床特征和危险因素。

Clinical characteristics and risk factors of organ failure and death in necrotizing pancreatitis.

机构信息

Second Clinical Medical College of Nanchang University, Nanchang, 330006, Jiangxi Province, China.

Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, 17 Yong Waizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China.

出版信息

BMC Gastroenterol. 2023 Jan 19;23(1):19. doi: 10.1186/s12876-023-02651-4.

Abstract

BACKGROUND

Organ failure (OF) and death are considered the most significant adverse outcomes in necrotizing pancreatitis (NP). However, there are few NP-related studies describing the clinical traits of OF and aggravated outcomes.

PURPOSE

An improved insight into the details of OF and death will be helpful to the management of NP. Thus, in our research, we addressed the risk factors of OF and death in NP patients.

METHODS

We performed a study of 432 NP patients from May 2017 to December 2021. All patients with NP were followed up for 36 months. The primary end-points were risk factors of OF and death in NP patients. The risk factors were evaluated by logistic regression analysis.

RESULTS

NP patients with OF or death patients were generally older, had a higher APACHE II score, longer hospital stay, longer ICU stay, as well as a higher incidence of severe acute pancreatitis (SAP), shock and pancreatic necrosis. Independent risk factors related to OF included BMI, APACHE II score and SAP (P < 0.05). Age, shock and APACHE II score (P < 0.05) were the most significant factors correlated with the risk of death in NP patients. Notably, increased mortality was linked to the number of failed organs.

CONCLUSIONS

NP is a potentially fatal disease with a long hospital or ICU stay. Our study indicated that the incidence of OF and death in NP patients was 69.9% and 10.2%, respectively. BMI, SAP, APACHE II score, age and shock are potential risk factors of OF and death in NP patients. Clinicians should focus on these factors for early diagnosis and appropriate therapy.

摘要

背景

器官衰竭(OF)和死亡被认为是坏死性胰腺炎(NP)中最严重的不良后果。然而,很少有 NP 相关研究描述 OF 和加重结局的临床特征。

目的

深入了解 OF 和死亡的细节将有助于 NP 的管理。因此,在我们的研究中,我们探讨了 NP 患者 OF 和死亡的危险因素。

方法

我们对 2017 年 5 月至 2021 年 12 月的 432 名 NP 患者进行了一项研究。所有 NP 患者均随访 36 个月。主要终点是 NP 患者 OF 和死亡的危险因素。采用 logistic 回归分析评估危险因素。

结果

NP 患者伴有 OF 或死亡的患者通常年龄较大,APACHE II 评分较高,住院时间、ICU 住院时间较长,SAP、休克和胰腺坏死的发生率较高。与 OF 相关的独立危险因素包括 BMI、APACHE II 评分和 SAP(P<0.05)。年龄、休克和 APACHE II 评分(P<0.05)是与 NP 患者死亡风险最显著相关的因素。值得注意的是,器官衰竭数量的增加与死亡率的增加有关。

结论

NP 是一种潜在致命疾病,住院或 ICU 时间长。我们的研究表明,NP 患者的 OF 发生率和死亡率分别为 69.9%和 10.2%。BMI、SAP、APACHE II 评分、年龄和休克是 NP 患者 OF 和死亡的潜在危险因素。临床医生应关注这些因素,以便进行早期诊断和适当治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d7b/9850524/b28ca44c7c07/12876_2023_2651_Fig1_HTML.jpg

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