Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2023; 15(8): 1712-1718
Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1712
Risk factors and their interactive effects on severe acute pancreatitis complicated with acute gastrointestinal injury
Jian-Hui Chen, Mei-Fen Zhang, Wen-Chao Du, Yan-An Zhang
Jian-Hui Chen, Mei-Fen Zhang, Wen-Chao Du, Yan-An Zhang, Emergency Department, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, Fujian Province, China
Author contributions: Chen JH designed and performed the research and wrote the paper; Zhang YA designed the research and supervised the report; Zhang MF designed the research and contributed to the analysis; Du WC supervised the report.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Longyan First Affiliated Hospital of Fujian Medical University (Approved No. LYREC2023-k016-01).
Informed consent statement: This was a retrospective study and was exempt from informed consent according to Institutional policy.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: The data used for this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-An Zhang, MBBS, Professor, Emergency Department, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyibei Road, Xinluo District, Longyan 364000, Fujian Province, China. zhangyanan6870@163.com
Received: May 6, 2023
Peer-review started: May 6, 2023
First decision: May 19, 2023
Revised: May 26, 2023
Accepted: June 21, 2023
Article in press: June 21, 2023
Published online: August 27, 2023
Abstract
BACKGROUND

There are many risk factors for severe acute pancreatitis (SAP) complicated with acute gastrointestinal injury (AGI), but few reports on the interaction between these risk factors.

AIM

To analyze the risk factors for SAP complicated with AGI and their interactive effects.

METHODS

We selected 168 SAP patients admitted to our hospital between December 2019 and June 2022. They were divided into AGI group and non-AGI group according to whether AGI was present. Demographic data and laboratory test data were compared between the two groups. The risk factors for SAP with concomitant AGI were analyzed using multifactorial logistic regression, and an analysis of the interaction of the risk factors was performed.

RESULTS

The percentage of patients with multiple organ dysfunction syndrome, acute physiological and chronic health scoring system II (APACHE II) score, white blood cell count and creatinine (CRE) level was higher in the AGI group than in the non-AGI group. There was a statistically significant difference between the two groups (P < 0.05). Logistic regression analysis indicated that an APACHE II score > 15 and CRE > 100 µmol/L were risk factors for SAP complicating AGI. The interaction index of APACHE II score and CRE level was 3.123.

CONCLUSION

An APACHE II score > 15 and CRE level > 100 µmol/L are independent risk factors for SAP complicated with AGI, and there is a positive interaction between them.

Keywords: Severe acute pancreatitis, Acute gastrointestinal injury, Risk factors, Interactions, Acute physiological and chronic health scoring system II, Creatinine

Core Tip: Acute gastrointestinal injury (AGI) is a common complication of severe acute pancreatitis (SAP). Patients with AGI are prone to gastrointestinal dysfunction and mucosal injury, aggravating the degree of pancreatic inflammation, causing multiple organ dysfunction and endangering patients' lives. In this study, 168 patients with SAP were divided into the AGI group and non-AGI group. The risk factors of SAP complicated with AGI were analyzed, and the interaction of these risk factors was analyzed. The study findings have guiding value for controlling the development of AGI and improving the prognosis of SAP.