Risk Management and Healthcare Policy (Aug 2021)
The Effect of Admission Serum Triglyceride Level on the Prediction of Severity of Acute Pancreatitis in Pregnancy
Abstract
Chengcheng Sheng, Ying Wang, Zongxu Xu, Jun Wang Department of Obstetrics and Gynecology, Shengjing Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, People’s Republic of ChinaCorrespondence: Jun WangDepartment of Obstetrics and Gynecology, Shengjing Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, 110004, People’s Republic of ChinaTel +86 18940254480Fax +86 24-23892620Email [email protected]: Previous studies indicated that the serum triglyceride level in patients with acute pancreatitis positively correlated with the severity of the disease among the general population. Despite the physiological hypertriglyceridemia in pregnant women, there are no reports on the relationship between serum triglyceride level and the severity of acute pancreatitis in pregnant (APIP) women. This study explores the relationship between serum triglyceride levels and the severity of APIP.Patients and Methods: Clinical information of APIP patients admitted to the Shengjing Affiliated Hospital of China Medical University was gathered from January 2012 to December 2020 to conduct retrospective research. The participating patients were divided into mild, moderately severe, and severe acute pancreatitis. The clinical outcomes of patients with different serum triglyceride levels (0– 2.3 mmol/L, 2.23– 5.65 mmol/L, 5.65– 11.2 mmol/l, ≥ 11.2 mmol/L) were analyzed by performing ordinal logistic regression analysis. Receiver operating curve analysis was used to calculate the threshold value of serum triglyceride concentration that can effectively predict the occurrence of severe acute pancreatitis (SAP).Results: Hypertriglyceridemic acute pancreatitis (HTG-AP) occurred in 47% of APIP patients within the group, with a high prevalence among the Han population. In the present study, the serum triglyceride concentration correlated positively with the severity of APIP (r=0.403, P < 0.05). The adjusted logistic model demonstrated that relative to nominal triglyceride levels, the OR value of SAP were 1.036 (95% CI: 0.401– 2.677), 3.429 (95% CI: 1.269– 9265), 8.329 (95% CI: 3.713– 18.682) with triglyceride at the level of 2.23– 5.65 mmol/L, 5.65– 11.2 mmol/l and ≥ 11.2 mmol/L. In APIP patients, a triglyceride concentration of 10.7mmol/L or more upon admission was a predictive value for the occurrence of SAP, with a sensitivity of 0.72 and a specificity of 0.65, AUC: 0.708 (95% CI: 0.620– 0.796).Conclusion: As the serum triglyceride level upon admission increased, the frequency of local and systemic complications increased significantly.Keywords: gestation, hypertriglyceridemia, acute pancreatitis, organ failure
