Echocardiography in acute pancreatitis: Mortality prediction and its value in guiding treatment

This study explores the value of echocardiography in predicting mortality and guiding treatment in patients with acute pancreatitis. This research retrospectively studied patients with acute pancreatitis (AP) who were treated at the Emergency Department of Beijing Shijitan Hospital between January of 2018 and October of 2021.In the 2012 updated Atlanta classification for acute pancreatitis, patients were categorized into two subgroups: the non-SAP group and the severe acute pancreatitis (SAP) group. The comprehensive score indices, blood-related indices, and echocardiography-related indices between the two groups were compared.Furthermore, logistic regression analysis was conducted on SAP indicators and mortality, resulting in the generation of an operating characteristic curve for subjects. The area under the curve was then analyzed to assess predictive efficiency. This retrospective study investigated a total of 253 patients, 159 male (62.85%) and 94 female (37.15%). APACHE II, BISAP, MCTSI, SOFA, cTnI, NTproBNP, E'/A', and SV were independent determinants for SAP; all AUCs were >0.7. The group of patients who did not survive showed notably elevated levels of cTnI, increased scores on various indices (APACHE II, SOFA, BISAP, and MCTSI), and decreased levels on echocardiography-related indices (E'/A′) compared to those who survived. Independent determinants for predicting mortality were identified using a multiple logistic regression model, with APACHE II, SOFA, BISAP, MCTSI, and E'/A′ being significant factors. All AUCs were >0.7. Echocardiographic indicators, E'/A′ and SV have acceptable predictive values for SAP and E'/A′ could be an independent predictor for mortality, which provides certain value in guiding clinical treatment for AP patients.