评估初始和复发性急性胰腺炎在重症监护病房中的差异
Wei Xu1, Lan Hu1, Shengyi Shi1
1Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Archives of medical science : AMS
|December 17, 2025
概括
复发性急性胰腺炎 (RAP) 患者的住院死亡率低于初始急性胰腺炎 (IAP) 患者. 简化急性生理学评分II (SAPS II) 最好预测IAP死亡率,而急性胰腺炎严重程度的床边指数 (BISAP) 评分显示了RAP的可能性.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 流行病学 流行病学
背景情况:
- 与初始急性胰腺炎 (IAP) 患者相比,复发性急性胰腺炎 (RAP) 患者可能会出现不那么严重的疾病和降低的死亡率.
- 有限的数据存在于RAP患者的结果,特别是在重症监护病房 (ICU).
研究的目的:
- 为了比较入院死亡率和住院时间,IAP和RAP患者被送往重症监护室.
- 在IAP和RAP组中确定住院死亡的独立风险因素.
- 评估各种评分系统在预测IAP和RAP患者死亡率方面的有效性.
主要方法:
- 利用密集护理医疗信息中心 (MIMIC-IV) 数据库提取IAP和RAP患者的数据.
- 分析了住院死亡率和住院/ICU停留时间作为主要结局.
- 采用双项逻辑回归,ROC曲线和DCA用于风险因素识别和预后模型评估.
主要成果:
- 与IAP (13.96%) 患者相比,RAP (3.57%) 的住院死亡率明显较低;住院/ICU没有显著差异.
- 对于IAP,查尔森并发症指数,BISAP和SIRS得分是独立的死亡风险因素. 萨普斯II显示出卓越的预测性能.
- 对于RAP,BISAP显示出死亡率预测的潜力,在特定值内表现优于其他得分.
结论:
- 与IAP相比,RAP与减少的严重程度和住院死亡率有关.
- 查尔森并发症指数,BISAP和SIRS是IAP死亡的风险因素,SAPS II是最佳预测工具.
- 在RAP患者的医院死亡率预测方面,BISAP得分显示出有前途.
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