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| Predictive value of P(v-a)CO2/C(a-v)O2 in the early phase of severe acute pancreatitis patients |
| Meng Zhao-quan, Zhang Chao-gui, Wang Gui-lin |
| Department of Emergency, the Second People′s Hospital of Yibin, Yibin 644000, China |
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Abstract Objective To investigate the predictive value of P(v-a)CO2/C(a-v)O2 in the early phase of severe acute pancreatitis (SAP) patients. Methods A total of 78 SAP patients were continuously enrolled from August 2017 to October 2018. After the treatment, according to whether P(v-a)CO2/C(a-v)O2 increased or not, the patients were divided into a study group (n=32 cases, increased) and a control group (n=46 cases, decreased). General clinical data, incidences of organ dysfunction and complications, clinical prognosis, and oxygen metabolism indexes were compared between the two groups, and the predictive value of oxygen metabolism indexes in SAP mortality was evaluated. Results Disease severity, CT score, regions of pancreatic necrosis and APACHEⅡ score in the study group were significantly higher than those in the control group (P＜0.05). Meanwhile,the incidences of complications such as shock, acute respiratory distress syndrome, acute kidney injury and infected pancreatic necrosis (IPN) in the study group were significantly higher than those in the control group.Additionally, IPN occurred earlier, ICU and hospital stay were longer, and the mortality was higher in the study group (all P＜0.05).Before the treatment, no significant difference were found in P(v-a)CO2/C(a-v)O2 between two groups. However, the study group showed significantly higher P(v-a)CO2/C(a-v)O2 after the treatment(mm Hg/mL: 2.51±1.37 vs.1.91±1.29,P=0.031), and P(v-a)CO2 and lactic acid in both before and after the treatment than those in the control group (P＜0.05).Multivariate Logistic regression analysis showed that the risk factors for SAP in-hospital mortality were P(v-a)CO2 (P=0.017) and lactic acid before the treatment (P=0.021) and P(v-a)CO2(P=0.009), P(v-a)CO2/C(a-v)O2(P=0.019) and lactic acid (P=0.023) after the treatment. ROC curve indicated that before treatment P(v-a)CO2 had the highest predictive value for SAP mortality, area under the curve was 0.762, and optimal diagnostic boundary value was 7.69 mm Hg. After the treatment, P(v-a)CO2/C(a-v)O2 showed the highest predictive value for SAP mortality, area under the curve was 0.840, and optimal diagnostic boundary value was 2.05 mm Hg/mL. Conclusion P(v-a)CO2/C(a-v)O2 showed good predictive value in the early phase of SAP patients, which was worthy of clinical promotion.
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| About author:: Meng Zhao-quan, E-mail:zlds1188@163.com |
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