Background: The present study aimed to investigate whether the ultra-early indicators can predict severity of acute hypertriglyceridemic pancreatitis (HTGP) and affect clinical decisions.
Methods: We performed an observational retrospective study with data from 110 enrolled patients with HTGP from January 2017 to February 2020. According to the final clinical outcome, HTGP patients were divided into MAP group and MSAP-SAP group. Demographic and clinical data were collected, and ultra-early indicators (serum calcium, TG, IL-6, D-dimer, HbAc1, arterial lactate) levels were measured within 6 h of admission. A multivariate logistic regression analysis model and receiver operating characteristic curve were adopted to evaluate the value of ultra-early indicators for identifying high-risk patients. The chi-square test method was used to estimate the time of hospitalization and complications in MSAP-SAP group after plasma exchange within or more than 24 hours.
Results: Of the 110 HTGP patients, a total of 56 patients with mild AP and 54 MSAP-SAP HTGP patients included. TG, IL-6, D-dimer, HbAc1, and arterial lactate levels which measured within 6 h after admission were significantly higher in the MSAP-SAP group, but serum calcium was significantly lower, versus the mild AP group. IL-6, D-dimer, and serum calcium were found to be risk factors for MSAP-SAP and could ultra-early predict HTGP severity, particularly within 6 hours of admission. We found that patients of MSAP-SAP treated with Blood purification within 24 hours of admission have shorter hospital stay time than over 24 hours of admission.
Conclusion: Ultra-early indicators of IL-6, D-dimer, and serum calcium may be useful biomarkers for assessing AP severity in HTGP patients within 6 hours. Early blood purification therapy should be taken for MSAP-SAP patients within 24 hours, because fewer patients could suffer from complications and more patients had shorter hospital stay time. While traditional treatment could be implemented for MAP patients to reduce medical expenses and still obtain good therapeutic effect. Keywords: Hypertriglyceridemic pancreatitis, Ultra-early indicators, Clinical decisions, Therapeutic effect