Çavuşoğlu Türker Betül, Ahbab Süleyman, Türker Fatih, Hoca Emre, Çiftçi Öztürk Ece, Kula Atay Can, Öztürk Hüseyin, Urvasızoğlu Ayşe Öznur, Kalaycı Nilsu, Koçak Erdem, Bulut Merve, Yasun Özge, Ataoğlu Hayriye Esra
Department of Internal Medicine, Haseki Health Training and Research Hospital, University of Health Sciences Türkiye, Istanbul 34130, Türkiye.
Department of Internal Medicine, Medical Faculty, Balıkesir University, Balıkesir 10050, Türkiye.
J Clin Med. 2024 Jun 11;13(12):3416. doi: 10.3390/jcm13123416.
: Acute pancreatitis (AP) is characterized by pancreatic gland inflammation, and its clinical course ranges from mild to severe. Predicting the severity of AP early and reliably is important. In this study, we investigate the potential use of the Controlling Nutritional Status (CONUT) score as a prognostic marker in acute pancreatitis. : We examined 336 patients who had been hospitalized with an AP diagnosis in the internal medicine clinic. The patients included in the study were followed up for 5 years. The study analyzed the specific variables of age, gender, and AP etiology as recorded biochemical parameters for all study participants and calculated the effects of age, sex, Bedside Index of Severity in AP (BISAP), the revised Atlanta classification, and the CONUT score on mortality. : When compared with surviving patients, non-surviving patients had higher scores for BISAP, CONUT, and the Atlanta Classification ( 0.001). In the non-surviving group, hemoglobin, lymphocyte, and albumin levels were significantly lower and creatinine, uric acid, and procalcitonin levels were significantly higher compared to the surviving group ( ˂ 0.001, 0.003, ˂0.001, ˂0.001, 0.005, ˂0.001, respectively). The multivariate analysis showed a significant association of mortality with age, CONUT, and BISAP scores ( ˂ 0.003, 0.001, 0.012 respectively). The CONUT score was separated into two groups based on the median value. The predicted survival time in the group with a CONUT score > 2 (53.8 months) was significantly lower than in the group with a CONUT score ≤ 2 (63.8 months). The cumulative incidence of all-cause mortality was significantly higher in the patients with higher CONUT scores. : This study has assigned the CONUT score as an independent risk factor for mortality in AP.
急性胰腺炎(AP)的特征是胰腺炎症,其临床病程从轻度到重度不等。早期且可靠地预测AP的严重程度很重要。在本研究中,我们调查了控制营养状况(CONUT)评分作为急性胰腺炎预后标志物的潜在用途。
我们检查了在内科门诊被诊断为AP而住院的336例患者。纳入研究的患者进行了5年的随访。该研究分析了所有研究参与者记录的生化参数中的年龄、性别和AP病因等特定变量,并计算了年龄、性别、急性胰腺炎床边严重程度指数(BISAP)、修订的亚特兰大分类和CONUT评分对死亡率的影响。
与存活患者相比,非存活患者的BISAP、CONUT和亚特兰大分类评分更高(P<0.001)。在非存活组中,与存活组相比,血红蛋白、淋巴细胞和白蛋白水平显著降低,而肌酐、尿酸和降钙素原水平显著升高(分别为P<0.001、P<0.003、P<0.001、P<0.001、P<0.005、P<0.001)。多变量分析显示死亡率与年龄、CONUT和BISAP评分显著相关(分别为P<0.003、P<0.001、P<0.012)。CONUT评分根据中位数分为两组。CONUT评分>2的组(53.8个月)的预测生存时间显著低于CONUT评分≤2的组(63.8个月)。CONUT评分较高的患者全因死亡率的累积发生率显著更高。
本研究已将CONUT评分确定为AP患者死亡的独立危险因素。