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老年急性胰腺炎患者的临床特征与转归

The Clinical Characteristics and Outcome of Elderly Patients With Acute Pancreatitis.

作者信息

Wang Qiu, Chen Yiqiu, Huang Ping, Su De, Gao Fei, Fu Xiaoyun, Fu Bao

出版信息

Pancreas. 2022;51(10):1284-1291. doi: 10.1097/MPA.0000000000002192.

Abstract

OBJECTIVES

This study aimed to identify the risk factors for the progression of acute pancreatitis (AP) to severe acute pancreatitis (SAP) and death in elderly patients.

METHODS

This was a single-center retrospective study conducted in a tertiary teaching hospital. Data on patient demographics, comorbidities, duration of hospitalization, complications, interventions, and mortality rates were collected.

RESULTS

Between January 2010 and January 2021, 2084 elderly patients with AP were included in this study. The mean age of the patients was 70.0 years (standard deviation, 7.1 years). Among them, 324 (15.5%) had SAP and 105 died (5.0%). The 90-day mortality rate in the SAP group was significantly higher than that in the AP group (P < 0.0001). Multivariate regression analysis revealed that trauma, hypertension, and smoking were risk factors for SAP. After multivariate adjustment, acute respiratory distress syndrome, acute kidney injury, sepsis, organ perforation, and abdominal hemorrhage were associated with higher 90-day mortality.

CONCLUSIONS

Traumatic pancreatitis, hypertension, and smoking are independent risk factors for SAP in elderly patients. Acute respiratory distress syndrome, acute kidney injury, sepsis, organ perforation, and abdominal hemorrhage are independent risk factors for death in elderly patients with AP.

摘要

目的

本研究旨在确定老年患者急性胰腺炎(AP)进展为重症急性胰腺炎(SAP)及死亡的危险因素。

方法

这是一项在三级教学医院进行的单中心回顾性研究。收集了患者的人口统计学数据、合并症、住院时间、并发症、干预措施及死亡率等资料。

结果

2010年1月至2021年1月期间,本研究纳入了2084例老年AP患者。患者的平均年龄为70.0岁(标准差7.1岁)。其中,324例(15.5%)发生SAP,105例死亡(5.0%)。SAP组的90天死亡率显著高于AP组(P<0.0001)。多因素回归分析显示,创伤、高血压和吸烟是SAP的危险因素。经过多因素调整后,急性呼吸窘迫综合征、急性肾损伤、脓毒症、器官穿孔和腹腔出血与90天死亡率较高相关。

结论

创伤性胰腺炎、高血压和吸烟是老年患者发生SAP的独立危险因素。急性呼吸窘迫综合征、急性肾损伤、脓毒症、器官穿孔和腹腔出血是老年AP患者死亡的独立危险因素。

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