Department of Medicine, National Taiwan University Cancer Center, National Taiwan University Hospital, Taipei, Taiwan; Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Population Health Research Center, National Taiwan University; Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
Dig Liver Dis. 2024 Jun;56(6):1023-1031. doi: 10.1016/j.dld.2023.12.010. Epub 2024 Jan 15.
Organ failure (OF) of acute pancreatitis (AP) significantly contributes to AP-related mortality. Non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with reduced complications of AP.
We aimed to investigate whether NSAIDs ameliorates SIRS and OF in patients with AP.
Eligible patients with AP were retrospectively identified in 4 hospitals between January 2015 and December 2018. Associations between peri-onset NSAIDs use (day -3 to day 3) and OF, persistent OF (POF), and SIRS within the first week were analyzed. Propensity score-matched (PSM) analysis and inverse probability of treatment-weighted (IPTW) analysis were used to estimate risk ratios.
Among 1,528 patients with AP (97 [6.3%] with NSAIDs use), 242 (15.8%) developed organ failure, 89 (5.8%) progressed to POF, and 27 (1.8%) died within 3 months. PSM analysis showed no association between peri-onset NSAIDs and OF (risk ratio [RR], 1.00; 95% confidence interval [CI], 0.46 to 2.15) and POF (RR, 0.80; 95% CI, 0.21 to 2.98). IPTW analysis yielded similar results. Patients with and without peri-onset NSAIDs use were comparable with respect to OF, POF, and SIRS across subgroups defined by COX-2 selectivity and dose.
Peri-onset NSAIDs use was not significantly associated with reduced OF.
急性胰腺炎（AP）的器官衰竭（OF）显著导致 AP 相关死亡率。非甾体抗炎药（NSAIDs）已被证明可减少 AP 的并发症。
我们旨在研究 NSAIDs 是否可改善 AP 患者的 SIRS 和 OF。
在 2015 年 1 月至 2018 年 12 月期间，我们在 4 家医院回顾性地确定了符合条件的 AP 患者。分析了发病前 3 天至发病后 3 天内使用 NSAIDs 与 OF、持续性 OF（POF）和发病后第 1 周内 SIRS 之间的关系。采用倾向评分匹配（PSM）分析和逆概率处理加权（IPTW）分析估计风险比。
在 1528 例 AP 患者中（97 例[6.3%]使用 NSAIDs），242 例（15.8%）发生器官衰竭，89 例（5.8%）进展为 POF，27 例（1.8%）在 3 个月内死亡。PSM 分析显示，发病前 NSAIDs 与 OF（风险比 [RR]，1.00；95%置信区间 [CI]，0.46 至 2.15）和 POF（RR，0.80；95%CI，0.21 至 2.98）之间无关联。IPTW 分析得出了相似的结果。在 COX-2 选择性和剂量定义的亚组中，发病前使用和不使用 NSAIDs 的患者在 OF、POF 和 SIRS 方面具有可比性。
发病前 NSAIDs 的使用与 OF 减少无显著相关性。
