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dc.contributor.authorYang, Xinmin
dc.contributor.authorZhang, Ruwen
dc.contributor.authorJin, Tao
dc.contributor.authorZhu, Ping
dc.contributor.authorYao, Linbo
dc.contributor.authorLi, Lan
dc.contributor.authorCai, Wenhao
dc.contributor.authorMukherjee, Rajarshi
dc.contributor.authorDu, Dan
dc.contributor.authorFu, Xianghui
dc.contributor.authorXue, Jing
dc.contributor.authorMartina, Reynaldo
dc.contributor.authorLiu, Tingting
dc.contributor.authorPendharkar, Sayali
dc.contributor.authorPhillips, Anthony R
dc.contributor.authorSingh, Vikesh K
dc.contributor.authorSutton, Robert
dc.contributor.authorWindsor, John A
dc.contributor.authorDeng, Lihui
dc.contributor.authorXia, Qing
dc.contributor.authorHuang, Wei
dc.date.accessioned2022-05-27T16:08:40Z
dc.date.available2022-05-27T16:08:40Z
dc.date.issued2022-05
dc.date.submitted2020-12-04
dc.identifier.issn0163-2116
dc.identifier.others10620-021-06982-8
dc.identifier.other6982
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/337559
dc.description.abstractBACKGROUND/AIMS: Stress hyperglycemia is common in critical illness but it has not been clearly studied in patients with acute pancreatitis (AP). This study aimed to investigate the specific blood glucose (BG) level that defines stress hyperglycemia and to determine the impact of stress hyperglycemia on clinical outcomes in AP patients. METHODS: AP patients admitted ≤ 48 h after abdominal pain onset were retrospectively analyzed. Patients were stratified by pre-existing diabetes and stress hyperglycemia was defined using stratified BG levels for non-diabetes and diabetes with clinical outcomes compared. RESULTS: There were 967 non-diabetic and 114 diabetic (10.5%) patients met the inclusion criteria and the clinical outcomes between these two groups were not significantly different. In non-diabetes, the cut-off BG level of ≥ 180 mg/dl was selected to define stress hyperglycemia with an 8.8-fold higher odds ratio for persistent organ failure (POF) (95% CI 5.4-14.3; P < 0.001). For diabetes, ≥ 300 mg/dl was selected with a 7.5-fold higher odds ratio for POF (95% CI 1.7-34.3; P = 0.009). In multivariable logistic regression, stress hyperglycemia was independently associated with POF, acute necrotic collection, major infection and mortality. The combination of BG and systemic inflammatory response syndrome (SIRS) score in predicting POF was better than SIRS or Glasgow score alone. CONCLUSIONS: This study identifies a cut-off BG level of ≥ 180 mg/dl and ≥ 300 mg/dl was optimal to define stress hyperglycemia for non-diabetic and diabetic AP patients, respectively. There was a significant relationship between stress hyperglycemia and adverse clinical outcomes.
dc.languageen
dc.publisherSpringer Science and Business Media LLC
dc.subjectOriginal Article
dc.subjectAcute pancreatitis
dc.subjectBlood glucose
dc.subjectStress hyperglycemia
dc.subjectDiabetes mellitus
dc.subjectPersistent organ failure
dc.subjectReceiver operating characteristic curve
dc.titleStress Hyperglycemia Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis.
dc.typeArticle
dc.date.updated2022-05-27T16:08:39Z
prism.endingPage1889
prism.issueIdentifier5
prism.publicationNameDig Dis Sci
prism.startingPage1879
prism.volume67
dc.identifier.doi10.17863/CAM.84968
dcterms.dateAccepted2021-03-30
rioxxterms.versionofrecord10.1007/s10620-021-06982-8
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.identifier.eissn1573-2568
pubs.funder-project-idNZ-China Strategic Research Alliance (2016YFE0101800)
pubs.funder-project-idNational Natural Science Foundation of China (81973632, 81774120, 81800575)
cam.issuedOnline2021-05-03


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