ObjectiveTo explore the value of capillary leakage index (CLI) in predicting the condition and evaluating the prognosis of patients with severe acute pancreatitis (SAP) complicated with acute lung injury (ALI).
MethodsA total of 78 SAP patients were selected as the study subjects, and divided into non-ALI group (n=40) and ALI group (n=38) based on whether acute lung injury occured.According to the 28-day survival status of the patients, they were divided into survival group (n=45) and death group (n=33).The clinical baseline data of SAP patients were analyzed; the correlation between CLI and acute physiology and chronic health evaluation scoring system (APACHEⅡ), modified CT severity index (MCTSI), and lactate was evaluated using Pearson correlation analysis; the prediction of CLI on the occurrence of ALI and risk of 28-day mortality was analyzed by ROC curve; the cumulative survival rate under different risk stratification levels of CLI was analyzed with Kaplan-Meier survival curve.
ResultsThe C-reactive protein (CRP), CLI, lactate level, MCTSI, and APACHEⅡ scores of patients in the ALI group were higher than those in the non-ALI group (P < 0.05 to P < 0.01);the serum albumin (ALB) level of patients in the ALI group was significantly lower than that in the non-ALI group (P < 0.01).There was no statistically significant difference in gender between the survival group and the death group (P>0.05);the age, CRP, CLI, lactate level, MCTSI, and APACHEⅡ scores of patients in the death group were higher than those in the survival group (P < 0.05 to P < 0.01);the ALB level of patients in the death group was significantly lower than that in the survival group (P < 0.01).There was a significant positive correlation between CLI and APACHEⅡ score, MCTSI, and lactate level of SAP patients at admission (P < 0.01).The area under the ROC curve of CLI for predicting SAP complicated with ALI and 28-day mortality was 0.802 (95%CI: 0.705-0.899) and 0.758 (95%CI: 0.651-0.865), respectively; the optimal cutoff values were 0.517 and 0.394, with corresponding CLI values of 9.335 and 9.770, sensitivity of 84.20% and 72.70%, and specificity of 67.50% and 67.70%, respectively.Based on the latest optimal cutoff value of 9.552, Kaplan-Meier survival curve analysis showed that the 28-day cumulative survival rate in the CLI>9.552 group was significantly lower than that in the CLI≤9.552 group (P < 0.01).
ConclusionsCLI can predict the occurrence of SAP complicated with ALI in the early stage and plays an important role in evaluating the prognosis of patient, especially for SAP patients with CLI>9.552, who have a higher risk of short-term mortality, which needs special attention from clinical doctors.
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