Evaluation and Early Diagnosis of Gastrointestinal Failure in Acute Pancreatitis

JIN Meng; ZHANG Huimin; CHEN Xuanfu; WU Meixu; WANG Zheng; GUO Mingyue; BAI Xiaoyin; YANG Hong; QIAN Jiaming

doi:10.3881/j.issn.1000-503X.11240

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Acta Academiae Medicinae Sinicae ›› 2020, Vol. 42 ›› Issue (1) : 47-54. DOI: 10.3881/j.issn.1000-503X.11240

Original Article

Evaluation and Early Diagnosis of Gastrointestinal Failure in Acute Pancreatitis

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Abstract

Objective To investigate the application of Acute Gastrointestinal Injury(AGI) grading in evaluating gastrointestinal failure in patients with acute pancreatitis(AP). Methods In this retrospective observational study,patients presented with moderate severe AP and severe AP in our hospital from October 2013 to October 2016 were consecutively enrolled.Logistic regression analysis and receiver operating characteristic curve were used to explore and evaluate potential predictors of gastrointestinal failure. Results A total of 202 patients were included in this study,with 90 cases(44.6%) identified as gastrointestinal failure.Survival curve showed significantly increased risk of death in patients with gastrointestinal failure(P < 0.05).Logistic regression analysis showed age(OR=1.06,95%CI:1.03-1.09,P<0.001),complaint of stopping flatus and defecation(OR=7.02,95%CI:2.08-23.66,P=0.002),increased counts of white blood cells in peripheral blood(OR=1.09,95%CI:1.02-1.17,P=0.015),decreased level of serum albumin(OR=0.93,95%CI:0.86-1.00,P=0.048),and increased level of serum creatinine at admission(OR=1.02,95%CI:1.01-1.04,P=0.001) were the independent risk factors of gastrointestinal failure.The area under curves of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and Beside Index for Severity in Acute Pancreatitis (BISAP) scores in diagnosing gastrointestinal failure were 0.999 and 0.782,respectively. Conclusions Gastrointestinal failure can remarkably increase the risk of death in patients with AP.Both APACHE Ⅱ and BISAP scores at admission are useful in diagnosing gastrointestinal failure in patients with AP.

Key words

acute pancreatitis / gastrointestinal failure / Acute Gastrointestinal Injury grade

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JIN Meng , ZHANG Huimin , CHEN Xuanfu , et al . Evaluation and Early Diagnosis of Gastrointestinal Failure in Acute Pancreatitis[J]. Acta Academiae Medicinae Sinicae. 2020, 42(1): 47-54 https://doi.org/10.3881/j.issn.1000-503X.11240

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Funding

Supported by the Chinese Academy of Medical Sciences Medicine and Health Technology Innovation Project(2016-12M-3-001)

the Health Research & Special Projects Grant of China(201002020)

the Foundation of the Ministry of Education of China for Outstanding Young Teachers in University(20101106120059)

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