Factors Influencing the Onset and Outcomes in Severe Acute Pancreatitis: A Clinical Study
نویسندگان
1 1. Department of Emergency Medicine, Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
2 1. Department of Emergency Medicine, Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
3 1. Department of Emergency Medicine, Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
4 1. Department of Emergency Medicine, Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
5 1. Department of Emergency Medicine, Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
6 Department of Emergency Medicine, Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
doi
10.22034/ircmj.2025.495305.1737چکیده
Background and Objectives: Severe acute pancreatitis (SAP) is a serious illness with high risks of complications and death. This study looks into how clinical features, inflammation, and biochemical markers in patients with SAP are related to survival and disease severity. Methods: The study is a single-center, prospective observational study that reviewed the records of 332 patients, including 202 with acute pancreatitis (AP) and 130 with SAP. We analyzed various clinical, blood, and biochemical markers, including white blood cells (WBC), platelet count, albumin, creatinine, C-reactive protein (CRP), and inflammatory cytokines (IL-6, TNF-α). We used statistical tests including multinomial and binary logistic regression and ROC analysis to find out which factors are linked to survival, disease severity (BISAP score), and prognosis in both groups. Results: There were no major differences between the AP and SAP groups in terms of age, sex, or lifestyle habits. However, SAP patients had higher levels of WBC, CRP, creatinine, BUN, triglycerides, and inflammatory markers, pointing to widespread inflammation and organ issues. Higher levels of BUN [HR = 1.04, 95% CI (0.88-1.24)], creatinine [HR = 0.95, 95% CI (0.83-1.09)], CRP [HR = 1.03, 95% CI (0.99-1.21)], IL-6 [HR = 1.08, 95% CI (0.95-1.09)], and TNF-α [HR = 1.13, 95% CI (0.95-1.23)] were strongly linked to lower survival rates in SAP patients. BISAP scores were closely tied to ALT, IL-6, TNF-α, and triglycerides, with IL-6 and TNF-α showing the strongest connection to disease severity. Conclusion: The study shows that markers of inflammation like IL-6 and TNF-α, along with kidney function markers such as BUN and creatinine, are important in predicting the severity and survival of SAP. These findings emphasize the need for early tracking of these markers.
