What question did this study set out to answer?

This study evaluates whether nitrogen and energy balance within five days can predict disease form and hospital mortality in acute pancreatitis patients.

February 26, 2026

Indicators of cumulative nitrogen balance and energy in early period of acute pancreatitis are associated with form of disease and in-hospital mortality

Puntos clave

This study evaluates whether nitrogen and energy balance within five days can predict disease form and hospital mortality in acute pancreatitis patients.
Conducted a prospective cohort study with 64 patients diagnosed with acute pancreatitis.
Monitored cumulative nitrogen and energy balance during early enteral nutrition over five days.
Nitrogen balance was determined by urinary nitrogen excretion, and resting energy requirement was assessed by indirect calorimetry.
Statistical analysis was conducted using SPSS-26 software.
Nitrogen balance significantly predicted severe acute pancreatitis with an AUC of 0.766 and a cut-off threshold of -86.4 g over five days.
The amount of nitrogen administered showed strong predictive value (AUC 0.822) with a cut-off of 23.24 g of nitrogen.
Energy balance also predicted severe disease (AUC 0.818) with a threshold of 10,105 kcal over five days.
Nitrogen balance was the best predictor for in-hospital mortality (AUC 0.832) with a cut-off of 8.6 g over five days.

Resumen

Objective. To evaluate cumulative nitrogen and energy balance within 5 days after admission as predictors of form of disease and in-hospital mortality in patients with acute pancreatitis (AP) undergoing early enteral nutrition. Material and methods. A prospective cohort single-center study included 64 patients with predictors of severe AP (APACHE II score >8, CRP>150 mg/L, SOFA score >2) who received early enteral nutrition for 5 days. Urinary nitrogen excretion was determined by urine urea, and nitrogen balance (NB) was subsequently calculated. Resting energy requirement (RER) was determined by indirect calorimetry (IC). Statistical analysis was performed using SPSS-26 software. Results. The following indicators can predict severe form of AP: NB (AUC 0.766, 95% CI 0.649—0.884; p<0.001, Se 0.710, Sp 0.667) with a cut-off threshold -86.4 g of nitrogen per 5 days, amount of nitrogen administered with enteral nutrition (AUC 0.822, 95% CI 0.716—0.928; p<0.001, Se 0.931, Sp 0.636) with a cut-off threshold of 23.24 g of nitrogen per 5 days and energy balance (AUC 0.818, 95% CI 0.713—0.922; p<0.001, Se 0.727, Sp 0.806) with a cut-off threshold 10105 kcal for 5 days. The most accurate model for in-hospital mortality was NB (AUC 0.832, 95% CI 0.722—0.962; p=0.0001, Se 0.600, Sp 0.891) with a cut-off threshold 8.6 g/nitrogen per 5 days, for patients with severe AP — nitrogen excretion with urine (AUC 0.741, 95% CI 0.667—0.875; p=0.043, Se 0.667, Sp 0.875) with a cut-off threshold 52.4 g/nitrogen for 5 days. Conclusion. Indicators of cumulative nitrogen and energy balance within 5 days after admission in early period of acute pancreatitis with predicted severe course of disease and early enteral nutrition may be used as predictors of severe form of disease and in-hospital mortality. The best predictors of severe AP were cumulative (over 5 days) nitrogen, energy and nitrogen intake during this period. The best predictor of in-hospital mortality was nitrogen balance over 5 days, for patients with severe disease (n=33) — nitrogen excretion with urine over 5 days.

Preguntar a la IA

Me gusta

Guardar

Cite This Study

Sivkov et al. (Tue,) studied this question.

synapsesocial.com/papers/699fe35995ddcd3a253e71f1 https://doi.org/https://doi.org/10.17116/anaesthesiology202601167

Preguntar a la IA

Me gusta

Guardar