Meng Yao, Zheng Xiaojie, Gao Fangbo, Chen Lan, Qiu Jing, Li Hongyu, Qi Xingshun
Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, 110840, China.
Postgraduate College, Dalian Medical University, Dalian, 116000, China.
Intern Emerg Med. 2023 Jun;18(4):1203-1212. doi: 10.1007/s11739-023-03243-6. Epub 2023 Mar 9.
Pancreatic encephalopathy (PE) is a lethal complication of acute pancreatitis (AP), but its clinical characteristics and prognosis remain obscure. Herein, we performed a systematic review and meta-analysis to evaluate the incidence and outcomes of PE in AP patients. PubMed, EMBASE, and China National Knowledge Infrastructure were searched. Based on the data from cohort studies, the incidence and mortality of PE in AP patients were pooled. Based on the individual data from case reports, logistic regression analyses were performed to identify the risk factors for death in PE patients. Among 6702 papers initially identified, 148 were included. Based on 68 cohort studies, the pooled incidence and mortality of PE in AP patients were 11% and 43%, respectively. The causes of death were clearly reported in 282 patients, of which the most common was multiple organ failure (n = 197). Based on 80 case reports, 114 AP patients with PE were included. The causes of death were clearly reported in 19 patients, of which the most common was multiple organ failure (n = 8). Univariate analyses showed that multiple organ failure (OR = 5.946; p = 0.009) and chronic cholecystitis (OR = 5.400; p = 0.008) were the significant risk factors of death among patients with PE. PE is not a rare complication of AP and indicates poor prognosis. Such a high mortality of PE patients may be attributed to its coexistence of multiple organ failure.
胰腺性脑病（PE）是急性胰腺炎（AP）的一种致命并发症，但其临床特征和预后仍不明确。在此，我们进行了一项系统评价和荟萃分析，以评估AP患者中PE的发生率和结局。检索了PubMed、EMBASE和中国知网。基于队列研究的数据，汇总了AP患者中PE的发生率和死亡率。基于病例报告的个体数据，进行逻辑回归分析以确定PE患者死亡的危险因素。在最初识别的6702篇论文中，纳入了148篇。基于68项队列研究，AP患者中PE的汇总发生率和死亡率分别为11%和43%。282例患者的死亡原因有明确报道，其中最常见的是多器官功能衰竭（n = 197）。基于80例病例报告，纳入了114例患有PE的AP患者。19例患者的死亡原因有明确报道，其中最常见的是多器官功能衰竭（n = 8）。单因素分析显示，多器官功能衰竭（OR = 5.946；p = 0.009）和慢性胆囊炎（OR = 5.400；p = 0.008）是PE患者死亡的重要危险因素。PE不是AP的罕见并发症，且提示预后不良。PE患者如此高的死亡率可能归因于其多器官功能衰竭的并存。
