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波兰急性胰腺炎的医院病死率及其预测因素:单中心经验。

Hospital mortality rate and predictors in acute pancreatitis in Poland: A single-center experience.

作者信息

Nawacki Łukasz, Głuszek Stanisław

机构信息

Collegium Medicum, The Jan Kochanowski University in Kielce, Poland.

Collegium Medicum, The Jan Kochanowski University in Kielce, Poland.

出版信息

Asian J Surg. 2024 Jan;47(1):208-215. doi: 10.1016/j.asjsur.2023.07.063. Epub 2023 Aug 3.

Abstract

BACKGROUND

Despite advances in medicine, acute pancreatitis remains a disorder that is associated with a high mortality rate. The objective of this study was to analyze in-hospital mortality in patients hospitalized with acute pancreatitis.

METHODS

A prospective analysis of patients hospitalized with acute pancreatitis in a single surgical center was performed. Etiological factors, concomitant diseases, age, and intensive care unit treatment status were assessed to determine their impact on the cause and time of patient death. In addition, conventional laboratory tests performed in the emergency ward were evaluated for their potential as predictors of mortality.

RESULTS

The study included 476 (n) patients hospitalized with acute pancreatitis in a single surgical center. The presentations included mild disease in 261 (54.8%) patients, moderate disease in 132 (27.7%) patients, and severe disease in 83 (17.5%) patients. The overall mortality rate was 7.14% (n = 34), including 41% in the severe disease group. The mean and median hospitalization times for these patients were 13.9 and 7 days, respectively. Respiratory failure is the main cause of patient death.

CONCLUSIONS

Acute pancreatitis remains one of the most common gastroenterological diseases that may lead to death. Acute pancreatitis-related respiratory failure is the most common cause of death among patients with alcohol etiology of the disease. Moreover, the mortality rate was higher among older patients. Therefore, actions should be taken to discover prognostic factors of the severe form and initiate appropriate treatment.

摘要

背景

尽管医学取得了进步,但急性胰腺炎仍然是一种死亡率较高的疾病。本研究旨在分析因急性胰腺炎住院患者的院内死亡率。

方法

对单一外科中心收治的急性胰腺炎患者进行前瞻性分析。评估病因、合并症、年龄和重症监护病房治疗情况,以确定其对患者死亡原因和时间的影响。此外,还评估了急诊科常规实验室检查对死亡率的预测价值。

结果

本研究纳入了单一外科中心收治的 476 例急性胰腺炎患者。临床表现包括轻度疾病 261 例(54.8%)、中度疾病 132 例(27.7%)和重度疾病 83 例(17.5%)。总死亡率为 7.14%(n=34),其中重度疾病组死亡率为 41%。这些患者的平均和中位住院时间分别为 13.9 天和 7 天。呼吸衰竭是患者死亡的主要原因。

结论

急性胰腺炎仍然是最常见的胃肠疾病之一,可能导致死亡。与酒精病因相关的急性胰腺炎患者中,与疾病相关的呼吸衰竭是最常见的死亡原因。此外,老年患者的死亡率更高。因此,应采取措施发现严重疾病的预后因素并启动适当的治疗。

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