Department of Critical Care Medicine, Yichang Central People's Hospital, Yichang, 443003, Hubei, China.
The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443003, Hubei, China.
Sci Rep. 2024 Nov 7;14(1):27113. doi: 10.1038/s41598-024-77842-4.
Acute pancreatitis (AP) can result in acute kidney injury (AKI), which is linked to poor outcomes. We aimed to assess the relationship between the hematocrit-to-albumin ratio (HAR) and AKI in this population. This retrospective cohort study included consecutive patients diagnosed with AP and admitted to hospital. Data were systematically extracted from electronic medical records, covering baseline demographic and clinical characteristics. Total 1514 AP patients were enrolled, with 17% (257/1514) developing AKI. Multivariable-adjusted regression analysis, curve fitting, threshold effects analyses, and subgroup analyses were conducted to evaluate the relationship between HAR and AKI incidence in AP patients. Compared to the reference tertile of HAR, the adjusted OR values for the lower and higher tertiles of HAR were 1.25 (95% CI, 0.82-1.91, P = 0.297) and 1.50 (95% CI, 1.03-2.20, P = 0.037), respectively, after adjusting for covariates. The curve fitting results showed a J-shaped relationship between HAR and AKI (non-linear, p = 0.001), with an inflection point of 8.969. Furthermore, validation using the Medical Information Mart for Intensive Care (MIMIC-IV) database AP population revealed a similar relationship with an inflection point at 10.257. Our findings suggest a J-shaped relationship between HAR and AKI in AP patients, indicating higher risk of AKI when HAR exceeds 8.969.
急性胰腺炎（AP）可导致急性肾损伤（AKI），与不良预后相关。我们旨在评估该人群中红细胞压积与白蛋白比值（HAR）与 AKI 之间的关系。这项回顾性队列研究纳入了连续诊断为 AP 并住院的患者。数据从电子病历中系统提取，涵盖基线人口统计学和临床特征。共纳入 1514 例 AP 患者，17%（257/1514）发生 AKI。采用多变量调整回归分析、曲线拟合、阈值效应分析和亚组分析来评估 HAR 与 AP 患者 AKI 发生率之间的关系。与 HAR 的参考三分位相比，HAR 的较低和较高三分位的调整 OR 值分别为 1.25（95%CI，0.82-1.91，P=0.297）和 1.50（95%CI，1.03-2.20，P=0.037），在调整了协变量后。曲线拟合结果显示 HAR 与 AKI 之间呈 J 形关系（非线性，p=0.001），拐点为 8.969。此外，使用医疗信息监护网络-IV（MIMIC-IV）数据库的 AP 人群进行验证也显示出类似的关系，拐点为 10.257。我们的研究结果表明，AP 患者 HAR 与 AKI 之间存在 J 形关系，提示 HAR 超过 8.969 时 AKI 风险增加。
