Takahashi Masaki, Takauji Shuhei, Hayakawa Mineji
Division of Acute and Critical Care Medicine, Department of Anaesthesiology and Critical Care Medicine Hokkaido University Graduate School of Medicine Sapporo Japan.
Acute Med Surg. 2025 Jan 3;12(1):e70033. doi: 10.1002/ams2.70033. eCollection 2025 Jan-Dec.
Hypothermia-associated pancreatitis lacks comprehensive understanding owing to limited studies exploring its mechanism, epidemiology, risk factors, and outcomes. We aimed to investigate the frequency, characteristics, and predictive factors associated with the development of acute pancreatitis in patients with accidental hypothermia.
This study comprised a post hoc analysis of data from a multicenter prospective observational study (ICE-CRASH study) conducted in 36 tertiary emergency hospitals in Japan. Patients aged ≥18 years with core body temperatures ≤32°C admitted to emergency departments between 2019 and 2022 were enrolled. We identified patients who developed acute pancreatitis within 1 week of admission and described their characteristics. Age, vital signs, and blood gas analysis data were analyzed as potential predictors of acute pancreatitis using receiver operating characteristic (ROC) curve analysis.
Of 421 eligible patients with accidental hypothermia, 16 (3.8%) developed acute pancreatitis within 1 week. The age distribution of patients with acute pancreatitis showed bimodal peaks around 50-80 years. Patients with acute pancreatitis had a higher proportion of alcohol consumption than those without acute pancreatitis. ROC curve analysis showed age and pH as significant factors; however, their predictive power was not high.
The incidence of acute pancreatitis was 3.8% in patients with accidental hypothermia with core body temperatures ≤32°C. An association was found between the development of acute pancreatitis and alcohol consumption. No strong predictors of acute pancreatitis were identified.
由于对低温相关性胰腺炎的机制、流行病学、危险因素及预后的研究有限，目前对其缺乏全面认识。我们旨在调查意外低温患者发生急性胰腺炎的频率、特征及预测因素。
本研究是对在日本36家三级急诊医院进行的一项多中心前瞻性观察研究（ICE-CRASH研究）的数据进行事后分析。纳入2019年至2022年间入住急诊科、年龄≥18岁且核心体温≤32°C的患者。我们确定了入院1周内发生急性胰腺炎的患者，并描述其特征。使用受试者工作特征（ROC）曲线分析将年龄、生命体征和血气分析数据作为急性胰腺炎的潜在预测因素进行分析。
在421例符合条件的意外低温患者中，16例（3.8%）在1周内发生急性胰腺炎。急性胰腺炎患者的年龄分布在50-80岁左右呈现双峰。与未发生急性胰腺炎的患者相比，发生急性胰腺炎的患者饮酒比例更高。ROC曲线分析显示年龄和pH值是显著因素；然而，它们的预测能力不高。
核心体温≤32°C的意外低温患者中急性胰腺炎的发生率为3.8%。发现急性胰腺炎的发生与饮酒之间存在关联。未发现急性胰腺炎的强预测因素。
