Blood Urea Nitrogen Elevation Is a Marker for Pediatric Severe Acute Pancreatitis
Blood Urea Nitrogen Elevation Is a Marker for Pediatric Severe Acute Pancreatitis
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DOI：
10.1097/mpa.0000000000001265
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发表时间：
2019-03-01
期刊：
影响因子：
2.9
通讯作者：
Abu-El-Haija, Maisam
中科院分区：
文献类型：
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作者：
Vitale, David S.;Hornung, Lindsey;Abu-El-Haija, Maisam
目的急性胰腺炎(AP)患者的自然病程可分为轻、重度急性胰腺炎(SAP)。方法前瞻性收集2013年3月至2017年1月在辛辛那提儿童医院医疗中心就诊的首发AP患儿的临床资料并进行分析。结果共118例患者进入分析，其中22例(18.6%)发展为SAP。发生SAP的患者血尿素氮(BUN)、镁(P=0.007.0 4)、血糖(P=0.0 3)、钠(P=0.0 3)和C反应蛋白(P=0.0 2)均显著高于正常对照组(P<0.0 1)。以BUN作为预测因子的Logistic回归模型优于其他变量组合(受试者操作特征曲线下面积0.75；95%可信区间0.61~0.89；敏感性63%；特异性81%；阳性预测值43%；阴性预测值91%)。结论本研究建立了以BUN升高作为SAP显著预测因子的预测模型。这一发现有助于及早识别患SAP风险较高的儿科患者。
Objective The natural course of patients who develop acute pancreatitis (AP) can range from mild to severe acute pancreatitis (SAP). The aim of this study was to evaluate for early predictors of developing SAP during the first episode of AP in a prospective pediatric cohort.Methods Clinical data were prospectively collected and subsequently analyzed for pediatric patients presenting with their first episode of AP between March 2013 and January 2017 to Cincinnati Children's Hospital Medical Center.Results A total of 118 patients were included in the analysis, and 22 (18.6%) developed SAP. Patients who developed SAP had significantly higher values of blood urea nitrogen (BUN) (P = 0.007), magnesium (P = 0.04), glucose (P = 0.03), sodium (P = 0.03), and C-reactive protein (P = 0.02). A logistic regression model with BUN as a predictor of SAP was superior to any other combination of variables (area under the receiver operating characteristic curve, 0.75; 95% confidence interval, 0.61-0.89; sensitivity, 63%; specificity, 81%; positive predictive value, 43%; negative predictive value, 91%).Conclusions This study generated a predictive model using elevated BUN as a significant predictor of SAP. The findings are useful for early identification of pediatric patients at higher risk of developing SAP.