Risk factors for secondary pancreatic infection in elderly patients with severe acute pancreatitis
Objective To analyze the risk factors of secondary pancreatic infection in elderly patients with severe acute pancreatitis(SAP)and observe the predictive value of acute physiological and chronic health score Ⅱ(APACHE Ⅱ),intercellular cell adhesion molecule-1(ICAM-1),peripheral blood inflammation indicators.Methods The retrospective analysis included 50 elderly SAP patients with secondary pancreatic infection and 50 elderly SAP patients without secondary pancreatic infection from March 2020 to March 2023,and were divided into the observation group and control group.Baseline data and APACHE Ⅱ,serum ICAM-1,neutrophil-lymphocyte ratio(NLR),interleukin(IL-8),and C-reactive protein(CRP)levels were compared between the two groups at admission.The factors affecting secondary pancreatic infection in elderly SAP patients were analyzed,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the indicators for secondary pancreatic infection in elderly SAP patients.Results Comorbid diabetes(P=0.013),receiving mechanical ventilation(P=0.015),time of bowel dysfunction(＞3 d)(P=0.041),duration of central venous retention(＞6 d)(P=0.041),and time of fasting(＞3 d)(P=0.001)were the independent risk factors for secondary pancreatic infections in elderly patients with SAP.Patients in the observation group had a higher APACHE Ⅱ score(t=8.150),ICAM-1(1=18.828),and NLR(1=16.737),IL-8(t=6.161),CRP(t=7.848)levels and were all significantly higher than those of the control group(all P＜0.05).The area under the curve(AUC)of individual and combined tests were 0.872,0.775,0.805,0.769,0.851 and 0.952,respectively,and the comparisons showed that the AUC of the combined tests were higher than those of each individual test(P＜0.05).Conclusions Secondary pancreatic infection in elderly SAP patients had high expression of APACHE Ⅱ score,serum ICAM-1,NLR,serum IL-8 and CRP level.All these indicators had high diagnostic value.Combined detection could improve the sensitivity and specificity of detection.
万方数据
维普
