Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Effects of acute kidney injury on acute pancreatitis patients’ survival rate in intensive care unit: A retrospective study
Ni Shi, Guo-Dong Sun, Yuan-Yuan Ji, Ying Wang, Yu-Cheng Zhu, Wan-Qiu Xie, Na-Na Li, Qiu-Yuan Han, Zhi-Dong Qi, Rui Huang, Ming Li, Zhen-Yu Yang, Jun-Bo Zheng, Xing Zhang, Qing-Qing Dai, Gui-Ying Hou, Yan-Song Liu, Hong-Liang Wang, Yang Gao
Ni Shi, Qiu-Yuan Han, Zhi-Dong Qi, Rui Huang, Ming Li, Zhen-Yu Yang, Jun-Bo Zheng, Xing Zhang, Qing-Qing Dai, Gui-Ying Hou, Yan-Song Liu, Hong-Liang Wang, Department of Critical Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China
Guo-Dong Sun, Yuan-Yuan Ji, Wan-Qiu Xie, Na-Na Li, Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Ying Wang, Department of Critical Care Medicine, The First People Hospital of Mudanjiang city, Mudanjiang 157000, Heilongjiang Province, China
Yu-Cheng Zhu, Department of Critical Care Medicine, The Hongxinglong Hospital of Beidahuang Group, Shuangyashan 155811, Heilongjiang Province, China
Yang Gao, Department of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical University, Harbin 150028, Heilongjiang Province, China
Author contributions: Shi N and Gao Y carried out the conception, design, definition of intellectual content, literature search, data acquisition, data analysis, and manuscript preparation; all authors participated in data acquisition, data analysis; Sun GD, Ji YY, Wang Y, Zhu YC, Xie WQ, Li NN, Han QY, Qi ZD, Huang R, Li M, Yang ZY, Zheng JB, Zhang X, Dai QQ, Hou GY, Liu YS, and Wang HL provided assistance for statistical analysis; Shi N, Wang HL, and Gao Y carried out literature search and manuscript editing; Wang HL, Sun GD, and Gao Y performed manuscript review; All authors have read and approved the content of the manuscript; and Shi N and Sun GD contributed equally to this work.
Supported by the Scientific Research Project of Heilongjiang Health and Family Planning Commission, No. 2018086 and No. 2018392.
Institutional review board statement: This study was approved by the Ethics Committee of The Second Affiliated Hospital of Harbin Medical University.
Informed consent statement: Due to the nature of retrospective study, the written informed consent of this study was waived.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Data sharing statement: No additional data are available.
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:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Yang Gao, MD, Department of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical University, Zhongyuan Avenue, Harbin 150028, Heilongjiang Province, China.
gaoyang0312@126.com
Received: March 4, 2021
Peer-review started: March 4, 2021
First decision: April 5, 2021
Revised: April 15, 2021
Accepted: August 23, 2021
Article in press: August 23, 2021
Published online: October 14, 2021
Processing time: 222 Days and 3.4 Hours
BACKGROUND
Acute kidney injury (AKI) is one of the most common acute pancreatitis (AP)-associated complications that has a significant effect on AP, but the factors affecting the AP patients’ survival rate remains unclear.
AIM
To assess the influences of AKI on the survival rate in AP patients.
METHODS
A total of 139 AP patients were included in this retrospective study. Patients were divided into AKI group (n = 72) and non-AKI group (n = 67) according to the occurrence of AKI. Data were collected from medical records of hospitalized patients. Then, these data were compared between the two groups and further analysis was performed.
RESULTS
AKI is more likely to occur in male AP patients (P = 0.009). AP patients in AKI group exhibited a significantly higher acute physiologic assessment and chronic health evaluation II score, higher Sequential Organ Failure Assessment score, lower Glasgow Coma Scale score, and higher demand for mechanical ventilation, infusion of vasopressors, and renal replacement therapy than AP patients in non-AKI group (P < 0.01, P < 0.01, P = 0.01, P = 0.001, P < 0.01, P < 0.01, respectively). Significant differences were noted in dose of norepinephrine and adrenaline, duration of mechanical ventilation, maximum and mean values of intra-peritoneal pressure (IPP), maximum and mean values of procalcitonin, maximum and mean serum levels of creatinine, minimum platelet count, and length of hospitalization. Among AP patients with AKI, the survival rate of surgical intensive care unit and in-hospital were only 23% and 21% of the corresponding rates in AP patients without AKI, respectively. The factors that influenced the AP patients’ survival rate included body mass index (BMI), mean values of IPP, minimum platelet count, and hospital day, of which mean values of IPP showed the greatest impact.
CONCLUSION
AP patients with AKI had a lower survival rate and worse relevant clinical outcomes than AP patients without AKI, which necessitates further attention to AP patients with AKI in surgical intensive care unit.
Core Tip: Acute pancreatitis (AP) has become a common gastrointestinal disorder in surgical intensive care unit, and excessive secretion and/or poor drainage of pancreatic juice are the essence of AP onset. Acute kidney injury (AKI) is a common complication of AP, which is ordinarily associated with adverse outcomes. Among AP patients with AKI, the survival rate of surgical intensive care unit and in-hospital were only 23% and 21% of the corresponding rates in AP patients without AKI, respectively. The factors that influenced the AP patients’ survival rate included body mass index (BMI), mean values of intra-peritoneal pressure, minimum platelet count, and hospital day, of which mean values of intra-peritoneal pressure showed the greatest impact.
