| Title | Risk Factors of Acute Pancreatitis (AP) Complicated with Systemic Inflammatory Response Syndrome (SIRS) |
| Abstract | ObjectiveAcute pancreatitis (Acute pancreatitis, AP) is a kind of inflammatory response caused by a variety of factors which activate the trypsin in the pancreas and then lead to the digestion of pancreatic tissue itself, edema, hemorrhage or necrosis. Systemic inflammatory response syndrome (Systemic inflammatory response syndrome, SIRS) is clarified from a new perspective on important physiology and pathology, and developmental process of multiple organ dysfunction syndrome (Multiple organ dysfunction syndrome, MODS). Acute pancreatitis with SIRS may have greater impact on the clinical patients, but it has been not fully understood. We demonstrate a preliminary study of the risk factors for acute pancreatitis complicated with systemic inflammatory response syndrome, and further provide guidance for diagnosis of the disease in clinical practice.MethodsRetrospective analysis of 105 cases of acute pancreatitis patients with demographic, clinical, biochemical and radiological information in our hospital (Ministry of Health–China-Japan Friendship Hospital) from January 2008 to December 2009.23 parameters were included in our study. Measured parameters were 9, including the number of hospitalization days, body temperature, respiratory rate, heart rate, total number of leukocytes, neutrophil count, serum albumin, the age, serum lactate dehydrogenase, height, BMI, serum creatinine, total cholesterol, fasting glucose, incidence of the number of days, total serum bilirubin, serum amylase, alanine aminotransferase and triglycerides. Classification parameters were 4, including the patient’s gender, etiology, blood type and severity of AP. All of the patients were divided into two groups:the control group–acute pancreatitis patients not complicated with systemic inflammatory response syndrome; the case group–acute pancreatitis patients complicated with systemic inflammatory response syndrome. The single-factor analysis (Two independent samples t-test, Wilcoxon Mann-Whitney test orχ2 test) was initially used to compare the parameters above. Next, the parameters which P<0.1 in the univariate analysis were brought into the multiple unconditional Logistic regression analysis, and thereby received the possible risk factors.ResultsIn the 105 cases of acute pancreatitis, male cases are 69(65.7%), female cases are (34.3%). Mild acute pancreatitis(MAP) are 84 cases(80%), severe acute pancreatitis(SAP) are 21 cases(20%). Gallstone pancreatitis are 22 cases (21%), alcoholic pancreatitis are 28 cases (26.7%), hyperlipidemia pancreatitis are 12 cases (11.4%), other unexplained pancreatitis are 43 cases (41%). In the case group (58 cases),39 cases of MAP and 19 cases of SAP.46 cases occurred SIRS within 24 hours after admission (43.8%),12 cases occurred SIRS more than 24 hours after admission (11.4%). Univariate analysis showed that the following 12 parameters are different, including patient’s age (P= 0.078), length of hospital stay (P=0.001), incidence of the number of days (P=0.003), type of AP(P <0.001), body temperature (P=0.008), respiratory rate (P<0.001),heart rate (P<0.001), white blood cell (WBC) count (P<0.001), neutrophil count(P<0.001), serum albumin (P =0.004), serum total bilirubin (P=0.027) and serum amylase (P=0.028). Multiple Logistic regression analysis showed that the following 3 parameters may be independent risk factors, including the respiratory rate (OR,15.669,95% confidence interval,2.65-92.641, P=0.002), neutrophil count (OR,11.764,95% confidence interval,2.481-55.778, P=0.002) and serum total bilirubin level (OR,5.407,95% confidence interval,1.193-24.513, P=0.029).ConclusionRespiratory rate, neutrophil count and serum total bilirubin level may be independent risk factors for acute pancreatitis complicated with systemic inflammatory response syndrome. These datas provide the basis to judge the disease for clinical assistant, but large-scale prospective clinical study is still in need to further confirm these results. |
| Category | Medical Paper |
| Keywords | acute pancreatitis, Risk factors, systemic inflammatory response syndrome, |
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| Pages | 192 |
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