YẾU TỐ LIÊN QUAN ĐẾN VIÊM TỤY CẤP MỨC ĐỘ NẶNG Ở BỆNH NHÂN CÓ ĐIỂM BISAP THẤP

Abstract

Objective: To determine the prevalence of severe acute pancreatitis (AP) and factors associated with severe AP according to the revised Atlanta classification of AP in patients with BISAP scores of < 3. Subjects and methods: It is a retrospective and prospective cohort study which was carried out at the Department of Gastroenterology of Cho Ray Hospital from August 2021 to May 2022. Results: Of the 134 patients participating in the study, there were 29 patients with severe AP, accounting for 21.6%. In terms of clinical characteristics, there were significant differences in mean pulse rate at admission, proportion of patients with respiratory rate ≥ 22 breaths/min and proportion of patients with systolic blood pressure ≤ 100 mmHg between the two groups with and without severe AP. Regarding laboratory characteristics and images of contrast-enhanced computed tomography of the abdomen, mean Hct, sodium, potassium, CRP levels, median levels of creatinine, AST, glucose, amylase, lipase, triglyceride, rate of pancreatic necrosis and free abdominal fluid were higher in the group of patients with severe AP and the differences were statistically significant. The two factors associated with severe AP through multivariable logistic regression analysis were respiratory rate ≥ 22 breaths/min (OR 63.52, 95% CI 7.14 - 564.76) and blood creatinine concentration (OR 30, 95, 95% CI 1.35-707.61). Conclusion: Respiratory rate ≥22 breaths/min and serum creatinine were two independent factors associated with severe AP in patients with BISAP score < 3.