Hemoconcentration is associated with early faster fluid rate and increased risk of persistent organ failure in acute pancreatitis patients

Tao Jin, Lan Li, Lihui Deng, Si Wen, Ruwen Zhang, Na Shi, Ping Zhu, Lan Lan, Ziqi Lin, Kun Jiang, Jia Guo, Tingting Liu, Anthony Philips, Xiaonan Yang, Vikesh K. Singh, Robert Sutton, John A. Windsor, Wei Huang, Qing Xia

Research output: Contribution to journalArticle

Abstract

Background: Controversies existed surrounding the use of hematocrit to guide early fluid therapy in acute pancreatitis (AP). The association between hematocrit, early fluid therapy, and clinical outcomes in ward AP patients needs to be investigated. Methods: Data from prospectively maintained AP database and retrospectively collected details of fluid therapy were analyzed. Patients were stratified into three groups: Group 1, hematocrit < 44% both at admission and at 24 h thereafter; Group 2: regardless of admission level, hematocrit increased and >44% at 24 h; Group 3: hematocrit >44% on admission and decreased thereafter during first 24 h. “Early” means first 24 h after admission. Baseline characteristics, early fluid rates, and clinical outcomes of the three groups were compared. Results: Among the 628 patients, Group 3 had a higher hematocrit level, greater baseline predicted severity, faster fluid rate, and more fluid volume in the first 24 h compared with Group 1 or 2. Group 3 had an increased risk for persistent organ failure (POF; odds ratio 2, 95% confidence interval [1.1–3.8], P = 0.03) compared with Group 1 after adjusting for difference in baseline clinical severity scores, there was no difference between Group 2 and Group 3 or Group 1. Multivariate regression analyses revealed that hemoconcentration and early faster fluid rate were risk factors for POF and mortality (both P < 0.05). Conclusions: Hemoconcentration is associated with faster fluid rate and POF in ward AP patients. Randomized trials comparing standardized early fast and slow fluid management is warranted.

Original languageEnglish (US)
Pages (from-to)684-691
Number of pages8
JournalJGH Open
Volume4
Issue number4
DOIs
StatePublished - Aug 1 2020

Keywords

  • acute necrotic collection
  • acute pancreatitis
  • fluid therapy
  • hemoconcentration
  • mortality
  • persistent organ failure

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Fingerprint Dive into the research topics of 'Hemoconcentration is associated with early faster fluid rate and increased risk of persistent organ failure in acute pancreatitis patients'. Together they form a unique fingerprint.

  • Cite this

    Jin, T., Li, L., Deng, L., Wen, S., Zhang, R., Shi, N., Zhu, P., Lan, L., Lin, Z., Jiang, K., Guo, J., Liu, T., Philips, A., Yang, X., Singh, V. K., Sutton, R., Windsor, J. A., Huang, W., & Xia, Q. (2020). Hemoconcentration is associated with early faster fluid rate and increased risk of persistent organ failure in acute pancreatitis patients. JGH Open, 4(4), 684-691. https://doi.org/10.1002/jgh3.12320