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老年患者急性胰腺炎的临床特征及预后不同:一项为期6年的单中心研究

The Clinical Characteristics and Outcomes of Acute Pancreatitis Are Different in Elderly Patients: A Single-Center Study over a 6-Year Period.

作者信息

Zhang Shihang, Chen Zhiyao, Hu Cheng, Zhu Ping, Jin Tao, Li Lan, Lin Ziqi, Shi Na, Zhang Xiaoxin, Xia Qing, Deng Lihui

机构信息

West China Centre of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

J Clin Med. 2024 Aug 16;13(16):4829. doi: 10.3390/jcm13164829.

Abstract

This study aims to analyze the clinical characteristics of elderly patients with acute pancreatitis (AP) and investigate the effects of age on the clinical outcomes of AP. Patients aged ≥ 18 years with AP admitted within 72 h from 1 September 2013 to 31 August 2019 were included. Patients were divided into elderly (≥60 years) and non-elderly (<60 years) groups. Clinical data and outcomes were compared. A total of 756 elderly and 4896 non-elderly patients with AP were included. The elderly patients had different etiological distributions and more severe clinical markers and scores. Age was an independent risk factor for mortality [odds ratio (OR): 2.911, 95% CI: 1.801-4.706, < 0.001], intensive care unit admission (OR: 1.739, 95% CI: 1.126-2.685, = 0.013), persistent organ failure (OR: 1.623, 95% CI: 1.326-1.987, < 0.001), multiple organ failure (OR: 1.757, 95% CI: 1.186-2.604, = 0.005), and infection (OR: 2.451, 95% CI: 1.994-3.013, < 0.001). Adjusted multiple logistic regression and trend analysis confirmed the risk of the age for the outcomes. The deaths of elderly patients showed a biphasic pattern with peaks in the first and fifth weeks, in contrast to the single peak in the first week in the non-elderly patients. Elderly patients with AP were associated with worse clinical outcomes. It is crucial to devote considerable attention to the optimization of therapeutic approaches to reduce late mortality in this group of patients.

摘要

本研究旨在分析老年急性胰腺炎(AP)患者的临床特征,并探讨年龄对AP临床结局的影响。纳入2013年9月1日至2019年8月31日期间72小时内入院的年龄≥18岁的AP患者。将患者分为老年组(≥60岁)和非老年组(<60岁)。比较临床资料和结局。共纳入756例老年AP患者和4896例非老年AP患者。老年患者病因分布不同,临床指标和评分更严重。年龄是死亡(比值比[OR]:2.911,95%可信区间[CI]:1.801 - 4.706,P<0.001)、入住重症监护病房(OR:1.739,95%CI:1.126 - 2.685,P = 0.013)、持续性器官衰竭(OR:1.623,95%CI:1.326 - 1.987,P<0.001)、多器官衰竭(OR:1.757,95%CI:1.186 - 2.604,P = 0.005)和感染(OR:2.451,95%CI:1.994 - 3.013,P<0.001)的独立危险因素。校正后的多因素logistic回归和趋势分析证实了年龄对结局的风险。老年患者的死亡呈双相模式,在第一周和第五周出现高峰,而非老年患者在第一周出现单峰。老年AP患者的临床结局较差。重视优化治疗方法以降低该组患者的晚期死亡率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56fb/11355819/88cc481eba9c/jcm-13-04829-g001.jpg

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