The impact of early triglyceride target achievement on hospitalization outcomes in the patients with hyperlipidemic acute pancreatitis

Huang Xiaodong; Xu Zhihong; Liu Siyao; Liu Xiong; Zheng Qingliu; Hu Jun; Huang Xianwei; Lin Jiyan

doi:10.3969/j.issn.1002-1949.2024.10.007

Abstract：Objective To investigate the effect of early triglyceride(TG)target achievement on hospitalization outcomes,including organ failure,death and local complications,in hyperlipidemic acute pancreatitis(HLAP)patients.Methods This retrospective cohort study included the data from 401 HLAP patients admitted to the First Affiliated Hospital of Xiamen University from January 1,2018 to December 31,2023.Patients were divided into two groups based on whether their TG levels had dropped below 5.65 mmol/L within 48 h of admission:the non-target group(109 cases)and the target group(292 cases).Basic demographics,laboratory data and endpoint events were collected and compared between the two groups.Univariate and multivariate Cox regression analyses evaluated the impact of early TG target achievement and other factors on the risk of endpoint events.Additionally,a propensity score matching(PSM)strategy was used to balance baseline differences between the two groups for further validation of the comparison results.Survival analysis was conducted by using Kaplan-Meier curves.Results Before PSM adjustment,initial blood glucose and TG levels were lower in the target group than in the non-target group(P＜0.05).The incidence of renal impairment and local complications during hospitalization was lower in the target group compared to the non-target group(P＜0.05).There were no significant differences in other organ failures,further development to severe acute pancreatitis and mortality rates(P＞0.05).Univariate Cox analysis showed that early TG target achievement,age,heart rate,systemic inflammatory response syndrome,white blood cell count,C-reactive protein,blood glucose and D-dimer levels were associated with local complications in HLAP patients(P＜0.05).Multivariate Cox analysis revealed that early TG target achievement was an independent protective factor for reducing the risk of local complications,while elevated D-dimer levels were an independent risk factor(P＜0.05).After PSM adjustment,17 of 91 patients in the target group and 30 of 91 patients in the non-target group experienced local complications.Kaplan-Meier curves showed that the cumulative rates of local complications were lower in the target group than in the non-target group(P＜0.05).There were no significant differences in the incidence of other endpoint events between the two groups.Conclusions Achieving early TG targets upon admission may reduce the risk of local complications during hospitalization in HLAP patients,providing valuable insights for clinical treatment.