Wenqing Shu1, Jianhua Wan2, Jie Chen3, Wenhua He4, Yin Zhu5, Nonghua Lu6, Liang Xia7. 1. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, PR China. Electronic address: 15170428125@163.com. 2. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, PR China. Electronic address: 18942337437@163.com. 3. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, PR China. Electronic address: 18270916863@163.com. 4. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, PR China. Electronic address: hewenhua@126.com. 5. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, PR China. Electronic address: zhuyin27@sina.com. 6. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, PR China. Electronic address: lunonghua@ncu.edu.cn. 7. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, PR China. Electronic address: xialiang79@163.com.
Abstract
PURPOSE: The present study aimed to research the relationships between arterial lactate levels and pancreatic infection in moderately severe acute pancreatitis. METHODS: This study retrospectively analyzed data from 503 patients with moderately severe acute pancreatitis from January 1, 2013, to March 31, 2018. The baseline characteristics on admission were compared between patients with and without elevated arterial lactate levels. The parameters and laboratory data were compared between patients with and without pancreatic infections at admission. Univariate and multivariate logistic regression analyses were used to assess the value of elevated arterial lactate levels for identifying high-risk patients. P ≤ 0.05 was considered statistically significant. RESULTS: A total of 49 (9.2%) patients were diagnosed with pancreatic infections. Compared with patients without pancreatic infections, pancreatic infection patients had significantly increased arterial lactate levels at admission (1.5 ± 0.7 vs. 2.5 ± 0.9; P < 0.01). Multivariate logic analysis still showed that higher arterial lactate levels in moderately severe acute pancreatitis was an independent risk factor for developing pancreatic infections (hazard ratio: 6.31, 95% CI 3.01-13.24; P < 0.01). Arterial lactate level ≥2.1 mmol/L and procalcitonin level ≥0.5 ng/mL at admission had area under the receiver operating characteristic curves of 0.83 and 0.72, with sensitivity of 67.2% and 87%, and specificity of 82.0% and 60%, respectively, for the prediction of pancreatic infection in moderately severe acute pancreatitis. CONCLUSIONS: Our results indicate that a higher arterial lactate level is independently associated with pancreatic infection in patients with moderately severe acute pancreatitis and may be used as a tool to identify high-risk patients.
PURPOSE: The present study aimed to research the relationships between arterial lactate levels and pancreatic infection in moderately severe acute pancreatitis. METHODS: This study retrospectively analyzed data from 503 patients with moderately severe acute pancreatitis from January 1, 2013, to March 31, 2018. The baseline characteristics on admission were compared between patients with and without elevated arterial lactate levels. The parameters and laboratory data were compared between patients with and without pancreatic infections at admission. Univariate and multivariate logistic regression analyses were used to assess the value of elevated arterial lactate levels for identifying high-risk patients. P ≤ 0.05 was considered statistically significant. RESULTS: A total of 49 (9.2%) patients were diagnosed with pancreatic infections. Compared with patients without pancreatic infections, pancreatic infectionpatients had significantly increased arterial lactate levels at admission (1.5 ± 0.7 vs. 2.5 ± 0.9; P < 0.01). Multivariate logic analysis still showed that higher arterial lactate levels in moderately severe acute pancreatitis was an independent risk factor for developing pancreatic infections (hazard ratio: 6.31, 95% CI 3.01-13.24; P < 0.01). Arterial lactate level ≥2.1 mmol/L and procalcitonin level ≥0.5 ng/mL at admission had area under the receiver operating characteristic curves of 0.83 and 0.72, with sensitivity of 67.2% and 87%, and specificity of 82.0% and 60%, respectively, for the prediction of pancreatic infection in moderately severe acute pancreatitis. CONCLUSIONS: Our results indicate that a higher arterial lactate level is independently associated with pancreatic infection in patients with moderately severe acute pancreatitis and may be used as a tool to identify high-risk patients.