Influencing factors for severe acute pancreatitis with sepsis
DOI:10.3969/j.issn.1001-5256.2021.04.030
- VernacularTitle:重症胰腺炎合并脓毒症的影响因素分析
- Author:
Chaoyun XIE
1
;
Ping ZHANG
;
Minkai WANG
Author Information
1. Emergency Department, The Third Affiliated Hospital of Guizhou Medical University, Duyun, Guizhou 558000, China
- Publication Type:Research Article
- Keywords:
Pancreatitis;
Sepsis;
Root Cause Analysis
- From:
Journal of Clinical Hepatology
2021;37(4):877-881
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate related factors for severe acute pancreatitis (SAP) with sepsis. MethodsA retrospective analysis was performed for the clinical data of 178 SAP patients who were admitted from January 2007 to March 2020, and according to the presence or absence of sepsis, they were divided into sepsis group with 56 patients and non-sepsis group with 122 patients. The t-test was used for comparison of continuous data between the two groups, and the chi-square test was used for comparison of categorical data between the two groups. A logistic regression model was used for multivariate analyses. ResultsThe incidence rate of sepsis was 31.46% in SAP patients. The univariate analysis showed that there were significant differences between the patients without sepsis and those with sepsis in APACHEⅡ score, blood glucose, blood calcium, serum total cholesterol, serum triglyceride, blood urea nitrogen, serum creatinine, serum albumin, admission to the intensive care unit, hypoxemia, deep venous catheterization, mechanical ventilation, surgical procedure, blood purification, indwelling urinary catheterization, and extent of pancreatic necrosis (all P＜0.05). The multivariate analysis showed that APACHEⅡ score (odds ratio ［OR］=6.748, 95% confidence interval ［CI］: 2.191-20.788, P＜0.05), hypoxemia (OR=3.383, 95% CI: 1.112-10.293, P＜0.05), blood glucose (OR=5.288, 95%CI: 1.176-23.781, P＜0.05), extent of pancreatic necrosis (OR=5.523, 95%CI: 1.575-19.360, P＜0.05), and serum creatinine (OR=5.012, 95%CI: 1.345-18.762, P＜0.05) were independent risk factors for infectious SAP with sepsis, while laparoscopic removal of focal necrotic tissue (OR=0.250, 95%CI: 0.066-0951, P＜0.05) was an independent protective factor against SAP with sepsis. ConclusionThere are several important measures to reduce SAP with sepsis, including blood glucose control, protection of the functions of important organs such as lungs and kidneys, application of minimally invasive surgery to remove focal necrotic tissue, and emphasis on the treatment of critically ill patients with a high degree of pancreatic necrosis.
