Zou Zhichao, Li Zhe, Wan Qihai, Wang Qianqian, Yu Yi
Department of Anesthesiology, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China.
Department of Intensive Care Medicine, Juancheng County People's Hospital, Heze, Shandong, China.
Front Nutr. 2025 Apr 28;12:1519112. doi: 10.3389/fnut.2025.1519112. eCollection 2025.
Acute pancreatitis (AP) is associated with significant global mortality and morbidity. Frailty, which can be assessed through clinical indicators and life history, is known to impact adverse outcomes across different medical conditions. The frailty index derived from laboratory tests (FI-Lab) is a novel approach to the quantification of frailty. This study sought to investigate the relationship between the FI-Lab and mortality among critically ill patients with AP.
We utilized data on patients diagnosed with AP from the Medical Information Mart for Intensive Care-IV database. The FI-Lab was calculated using a specific set of laboratory parameters indicative of physiological disturbances. The primary outcomes examined were 30-day and 90-day mortality rates. Multivariate Cox regression was used for the statistical analysis, with adjustments for age, gender, Acute Physiology and Chronic Health Evaluation II scores, and other variables. Propensity matching scores were used to ensure the robustness of our findings.
A total of 1,116 AP patients were included in the analysis (mean age = 58.4 years; 57.9% male). Each 0.1 increment of FI-Lab was found to increase the risks of 30-day and 90-day mortality by 30% (hazard ratio (HR) = 1.30, < 0.001 for both). The propensity score matching (PSM) analysis validated these results. The FI-Lab demonstrated an association with acute kidney injury and the requirement for continuous renal replacement therapy. However, these associations were not significant after the PSM analysis.
An elevated FI-Lab was associated with higher mortality rates among critically ill AP patients. Randomized controlled trials are needed to confirm these findings and to explore their clinical implications.
急性胰腺炎（AP）在全球范围内导致了显著的死亡率和发病率。衰弱可通过临床指标和生活史进行评估，已知其会影响不同医疗状况下的不良结局。基于实验室检查得出的衰弱指数（FI-Lab）是一种量化衰弱的新方法。本研究旨在调查FI-Lab与重症AP患者死亡率之间的关系。
我们利用重症监护医学信息数据库-IV中诊断为AP的患者数据。FI-Lab通过一组指示生理紊乱的特定实验室参数进行计算。所考察的主要结局为30天和90天死亡率。采用多变量Cox回归进行统计分析，并对年龄、性别、急性生理与慢性健康状况评分II以及其他变量进行了调整。倾向匹配得分用于确保我们研究结果的稳健性。
共有1116例AP患者纳入分析（平均年龄=58.4岁；57.9%为男性）。发现FI-Lab每增加0.1，30天和90天死亡率的风险增加30%（风险比（HR）=1.30，两者均P<0.001）。倾向得分匹配（PSM）分析验证了这些结果。FI-Lab与急性肾损伤以及持续肾脏替代治疗的需求相关。然而，PSM分析后这些关联并不显著。
FI-Lab升高与重症AP患者较高的死亡率相关。需要进行随机对照试验来证实这些发现并探索其临床意义。
