Nosocomial mortality and early prediction of patients with severe acute pancreatitis.
OBJECTIVE
The aim of this study is to analyze factors (especially serum total cholesterol) that can enable early prediction of in-hospital mortality of patients with severe acute pancreatitis (SAP).


METHODS
Predictive factors (especially serum total cholesterol) for in-hospital mortality were evaluated retrospectively from the clinical data obtained from 338 SAP patients in our hospital from January 1999 to January 2008, who underwent intensive care, blood routine, blood biochemical tests and even computed tomography at the time of admission.


RESULTS
This analysis revealed that within 24 h after admission, serum total cholesterol (TC) was a mortality-reduced factor when it is between 4.37 mmol/L and 5.23 mmol/L (P < 0.05). Evaluated TC was accompanied by decreased C-reactive protein (CRP). CRP > 170 mg/L and albumin (ALB) < 30 g/L increased the fatal outcome (P < 0.05). Low albumin was a stronger predictor than CRP.


CONCLUSIONS
Within 24 h after admission, moderate elevation of TC level seemed to increase the resistance to inflammation and hence improved the survival rate in patients with SAP, and reduced the in-hospital mortality. Inflammatory reaction (with or without infection), hypoalbuminemia and TC were prognostic factors for in-hospital mortality; both high levels of CRP and low ALB levels were associated with in-hospital mortality in patients with SAP.
Wang
Xin
X
Department of Tianjin, Medical University, Tianjin, China.
Cui
Zhuang
Z
Li
Hechao
H
Saleen
Ali F
AF
Zhang
Dapeng
D
Miao
Bin
B
Cui
Yunfeng
Y
Zhao
Erpeng
E
Li
Zhonglian
Z
Cui
Naiqiang
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D002681:China; D002784:Cholesterol / Q000097:blood*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000401:mortality*; D034141:Hypoalbuminemia / Q000401:mortality; D007249:Inflammation / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010195:Pancreatitis / Q000097:blood / Q000401:mortality* / Q000628:therapy; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers; D012709:Serum Albumin; D002097:C-Reactive Protein; D002784:Cholesterol