MỐI LIÊN QUAN GIỮA DỊCH TỰ DO Ổ BỤNG VÀ VIÊM TỤY CẤP MỨC ĐỘ NẶNG

Abstract

Objective: To determine the prevalence of abdominal free fluid in patients with AP. To compare CRP levels, rates of complications (pancreatic necrosis, splanchnic vein thrombosis, pleural effusion), severity, organ failure, and outcomes (death, invasive mechanical ventilation, length of stay) in patients with AP with and without abdominal free fluid. To determine the role of abdominal free fluid as a risk factor for severe AP. Subjects and methods: It is a retrospective and prospective cross-sectional study which was carried out at the Department of Gastroenterology of Cho Ray Hospital from August 2021 to March 2022. Results: There are a total of 122 patients with acute pancreatitis. The rate of patients with abdominal free fluid is 58.2%. There was no difference in clinical features between the two groups with and without abdominal free fluid. CRP concentrations (mg/L) in the group with and without abdominal free fluid were 262.9 ± 14.7 and 198.6 ± 19.4, respectively (p=0.008). The rates of pancreatic necrosis, splanchnic vein thrombosis, pleural effusion in the group with and without abdominal free fluid were 53.5% and 25.5% (p=0.002), 22.5% and 2.0% (p=0.001), 59.2% and 17.7% (p<0.001). The rate of severe AP was higher in the group with abdominal free fluid (46.5%) than in the group without abdominal free fluid (17.7%) (p=0.002). There was a significant difference in the rate of respiratory failure, persistent respiratory failure in the group of patients with and without abdominal free fluid (p<0.001). There was no difference in circulatory failure, renal failure, multi-organ failure, invasive mechanical ventilation and length of hospital stay between the two groups. Multivariable logistic regression analysis showed that abdominal free fluid is a risk factor for severe AP with odds ratio (OR) 10.02, 95% CI: 1.7-59.7, p=0.011. Conclusion: There were differences in CRP levels, the rate of pancreatic necrosis, splanchnic vein thrombosis, pleural effusion, severe acute pancreatitis, respiratory failure and persistent respiratory failure between the two groups with and without abdominal free fluid. Abdominal free fluid is a risk factor for severe AP.