Abstract
BackgroundThere are few reports about the effect of glucocorticoids in the treatment of acute pancreatitis in humans. This study aims to evaluate the effect of glucocorticoids in the treatment of acute pancreatitis by propensity score matching analysis.ResultsAcute pancreatitis patients admitted between 2014 and 2019 were collected from the database and analyzed. Included patients were divided into the glucocorticoids-used group (GC group) and the non-glucocorticoids-used group (NGC group) according to whether glucocorticoids were used. A total of 818 eligible patients were included in the final analysis. Seventy-six patients were treated with glucocorticoids, and 742 patients were treated without glucocorticoids. Before propensity score matching, the triglyceride levels (38.2 ± 18.5 vs. 20.2 ± 16.8, P < 0.05) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (7.1 ± 2.5 vs. 4.5 ± 2.1, P < 0.05) at admission were significantly higher in the GC group than in the NGC group. The incidence of multi-organ failure (33.3% vs. 11.9%, P < 0.05) was significantly higher in the GC group than in the NGC group. Patients in the GC group showed a positive balance of fluid intake and output over 72 h. After 1:1 propensity score matching, 59 patients from each group (GC and NGC) were included in the analysis. There were no significant differences in age, sex, body mass index, triglycerides, or APACHE II scores between the two groups (P > 0.05), and the patients’ clinical outcomes were reversed. The proportion of patients with organ failure (40.7% vs. 52.5%, p < 0.05) and multi-organ failure (35.0% vs. 67.7%, P < 0.05) was significantly lower in the GC group than in the NGC group. Furthermore, patients in the GC group had significantly shorter lengths of hospital stay (12.9 ± 5.5 vs. 16.3 ± 7.7, P < 0.05) and costs (25,348.4 ± 2512.6vs. 32,421.7 ± 2813.3, P < 0.05) than those in the NGC group.ConclusionsThis study presents preliminary confirmation of the beneficial effect of glucocorticoids in the treatment of acute pancreatitis. More high-quality prospective studies are needed in the future.
Highlights
Acute pancreatitis (AP) is a commonly occurring acute abdominal disease with multiple causes [1]
AP patients complicated with immune deficiency, pregnancy, or malignancy were excluded from this study
The serum TGs (38.2 ± 18.5 vs. 20.2 ± 16.8, P = 0.005 < 0.05) and APACHE II scores (7.1 ± 2.5 vs. 4.5 ± 2.1, P = 0.034 < 0.05) at admission were significantly higher in the GC group than in the NGC group
Summary
Acute pancreatitis (AP) is a commonly occurring acute abdominal disease with multiple causes [1]. During the Glucocorticoids (GCs) are broad-spectrum inflammation-suppressing drugs that exert a broad range of anti-inflammatory effects [5]. GCs are considered to have beneficial, though debatable, effects in a series of other inflammatory diseases, including sepsis shock [8], community-acquired pneumonia [9], burns [10], and acute respiratory distress syndrome (ARDS) [11]. There are few reports about the effect of glucocorticoids in the treatment of acute pancreatitis in humans. This study aims to evaluate the effect of glucocorticoids in the treatment of acute pancreatitis by propensity score matching analysis
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