Analysis of factors influencing the complications of severe acute pancreatitis combined with hemorrhage
- 1Department of Gastroenterology, the 1st affiliated hospital, Jiangxi Medical College, Nanchang University
- 2Department of Pharmacy, the 1st affiliated hospital, Jiangxi Medical College, Nanchang University
- 3Department of Intensive Care Unit, the 1st affiliated hospital, Jiangxi Medical College, Nanchang University
Abstract
Background Complications of hemorrhage in patients with severe acute pancreatitis (SAP) significantly impact prognosis. However, current research on this topic remains limited. This study aims to analyze the factors influencing hemorrhage in SAP patients. Methods This study retrospectively analyzed clinical data from SAP patients admitted to our hospital between January 2019 and December 2022. Using propensity score matching and multivariate logistic regression analysis, we identified independent factors influencing hemorrhage. Additionally, we developed a nomogram prediction model for bleeding in SAP patients and generated an ROC curve to assess its accuracy. Prognosis was also evaluated. Results Based on the exclusion criteria, 804 patients were included in the study, with 97 (12.1%) experiencing hemorrhagic complications. After applying propensity score matching, 440 patients were selected, including 88 with bleeding. Multivariate logistic regression analysis identified several independent factors influencing hemorrhage in SAP: computed tomography severity index (CTSI) score (OR: 1.771, 95% CI: 1.434–2.187, P < 0.001), infected pancreatic necrosis (IPN) (OR: 4.407, 95% CI: 1.854–10.476, P < 0.001), acute physiology and chronic health evaluation II (APACHE II) score ≥ 15 (OR: 12.323, 95% CI: 5.015–30.282, P < 0.001), abdominal compartment syndrome (ACS) (OR: 3.685, 95% CI: 1.462–9.287, P = 0.006), and continuous renal replacement therapy (CRRT) (OR: 0.251, 95% CI: 0.094–0.670, P = 0.006). A nomogram prediction model was constructed, achieving an area under the ROC curve (AUC) of 0.924. The median ICU stay and total hospital stay were significantly longer in the bleeding group compared to the non-bleeding group (30 vs. 7 and 48 vs. 18, P < 0.001). Additionally, the mortality rate was significantly higher in the bleeding group compared to the non-bleeding group (46.6% vs. 6.5%, P < 0.001). Conclusion The occurrence of bleeding complications in SAP signifies a poor prognosis. Therefore, for patients with elevated CTSI and APACHE II scores, especially those with IPN and ACS, it is crucial to enhance monitoring for bleeding. If necessary, CRRT may be implemented to improve the condition and reduce the risk of hemorrhage.
Related
- Early Laparoscopic Cholecystectomy for Acute Gallstone Pancreatitis: Retrospective Review of Factors Influencing Timing of Surgery and Outcomes in a Single Institution
- Neurodevelopmental Trajectories and Neurodevelopmental Disorders Following Neonatal Intracranial Hemorrhage: A Long-Term Follow-Up Study and Analysis of Influencing Factors
- A gastric dieulafoy lesion presenting with life-threatening upper gastrointestinal hemorrhage during recovery from hypertriglyceridemic acute pancreatitis: a case report.
- Immature neutrophil response is associated with cardiac complications after non-traumatic subarachnoid hemorrhage.
- Correlation of red cell distribution width-to-albumin ratio combined with SOFA score with 28-day all-cause mortality in patients with acute pancreatitis: A retrospective study based on the MIMIC-IV database
BibTeX
@article{shao2026analysis,
title = {{Analysis of factors influencing the complications of severe acute pancreatitis combined with hemorrhage}},
author = {Liang Shao and Jianhua Wan and Wenhua He and Yong Zhu and Yin Zhu and Jing Liu and Fen Liu and Nonghua Lu and Liang Xia},
journal = {BMC Gastroenterology},
year = {2026},
month = jul,
doi = {10.1186/s12876-026-05154-0},
url = {https://doi.org/10.1186/s12876-026-05154-0},
note = {CC BY},
}
RIS
TY - JOUR
TI - Analysis of factors influencing the complications of severe acute pancreatitis combined with hemorrhage
AU - Liang Shao
AU - Jianhua Wan
AU - Wenhua He
AU - Yong Zhu
AU - Yin Zhu
AU - Jing Liu
AU - Fen Liu
AU - Nonghua Lu
AU - Liang Xia
PY - 2026
DA - 2026/07/01
JO - BMC Gastroenterology
DO - 10.1186/s12876-026-05154-0
UR - https://doi.org/10.1186/s12876-026-05154-0
AB - Background Complications of hemorrhage in patients with severe acute pancreatitis (SAP) significantly impact prognosis. However, current research on this topic remains limited. This study aims to analyze the factors influencing hemorrhage in SAP patients. Methods This study retrospectively analyzed clinical data from SAP patients admitted to our hospital between January 2019 and December 2022. Using propensity score matching and multivariate logistic regression analysis, we identified independent factors influencing hemorrhage. Additionally, we developed a nomogram prediction model for bleeding in SAP patients and generated an ROC curve to assess its accuracy. Prognosis was also evaluated. Results Based on the exclusion criteria, 804 patients were included in the study, with 97 (12.1%) experiencing hemorrhagic complications. After applying propensity score matching, 440 patients were selected, including 88 with bleeding. Multivariate logistic regression analysis identified several independent factors influencing hemorrhage in SAP: computed tomography severity index (CTSI) score (OR: 1.771, 95% CI: 1.434–2.187, P < 0.001), infected pancreatic necrosis (IPN) (OR: 4.407, 95% CI: 1.854–10.476, P < 0.001), acute physiology and chronic health evaluation II (APACHE II) score ≥ 15 (OR: 12.323, 95% CI: 5.015–30.282, P < 0.001), abdominal compartment syndrome (ACS) (OR: 3.685, 95% CI: 1.462–9.287, P = 0.006), and continuous renal replacement therapy (CRRT) (OR: 0.251, 95% CI: 0.094–0.670, P = 0.006). A nomogram prediction model was constructed, achieving an area under the ROC curve (AUC) of 0.924. The median ICU stay and total hospital stay were significantly longer in the bleeding group compared to the non-bleeding group (30 vs. 7 and 48 vs. 18, P < 0.001). Additionally, the mortality rate was significantly higher in the bleeding group compared to the non-bleeding group (46.6% vs. 6.5%, P < 0.001). Conclusion The occurrence of bleeding complications in SAP signifies a poor prognosis. Therefore, for patients with elevated CTSI and APACHE II scores, especially those with IPN and ACS, it is crucial to enhance monitoring for bleeding. If necessary, CRRT may be implemented to improve the condition and reduce the risk of hemorrhage.
SN - 1471-230X
ER -