Purpose To explore the prognostic value of albumin corrected anion gap (ACAG) within 24 hours of admission to the intensive care unit (ICU) for acute pancreatitis (AP). Patients and Methods This was a retrospective cohort study. Adult AP patients admitted to ICU from June 2016 to December 2019 were included in the study, who were divided into three groups according to initial serum ACAG within 24 hours upon ICU admission: ACAG ≤ 14.87 mmol/L, 14.87 < ACAG ≤ 19.03 mmol/L, and ACAG > 19.03 mmol/L. The primary study outcome indicator was in-hospital mortality. Age, sex, Glasgow Coma Scale score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were matched through propensity score matching (PSM) method to balance the baseline between the survivors and non-survivors. Multivariate Cox regression was used to determine the relationship between ACAG and in-hospital mortality. Results A total of 344 patients (of them 81 non-survivors) were analyzed in this study. Patients with higher ACAG intended to present significantly higher in-hospital mortality, APACHE II score, creatine, lower albumin, and bicarbonate. Multivariate Cox regression analysis after matching demonstrated that white blood cell count, platelet count, and higher ACAG were independently associated with higher in-hospital mortality (ACAG ≤ 14.87 as a reference, 14.87 < ACAG ≤ 19.03 mmol/L with HR of 2.34 and 95% CI of 1.15–4.76, ACAG >19.03 with HR of 3.46 and 95% CI of 1.75–6.84). Conclusion Higher ACAG was independently associated with higher in-hospital mortality in patients with AP after matching the baseline between the survivors and non-survivors.

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BackgroundThe Controlling Nutritional Status (CONUT) score was designed to assess the immune-nutritional status in patients. This study aimed to investigate the role of the CONUT score in the short-term prognosis of severe acute pancreatitis.MethodsThis was a retrospective cohort study. 488 patients with severe acute pancreatitis at the Department of Critical Care Medicine of the West China Hospital of Sichuan University (Chengdu, China) were enrolled in the study. Baseline data were collected from the West China Hospital of Sichuan University database. The primary outcome during follow-up was all-cause mortality. The secondary outcomes were 28 day mortality, renal insufficiency, length of stay (LOS) in the ICU, and length of stay (LOS) in the hospital. Patients were divided into two groups based on a median CONUT score of 7, and baseline differences between the two groups were eliminated by propensity matching. Univariate Cox regression analyses were performed to estimate the association between CONUT score and outcomes. The Kaplan–Meier method was used to estimate the survival rate of patients.ResultsCONUT score was an independent predictor of all-cause mortality (hazard ratio [HR]:2.093; 95%CI: 1.342–3.263; p &lt; 0.001) and 28 day mortality (hazard ratio [HR]:1.813; 95%CI: 1.135–2.896; p &lt; 0.013). CONUT score was not statistically significant in predicting the incidence of renal insufficiency. The high CONUT group had significantly higher all-cause mortality (p &lt; 0.001), and 28 day mortality (p &lt; 0.011) than the low CONUT group.ConclusionThe CONUT score is an independent predictor of short-term prognosis in patients with severe acute pancreatitis, and timely nutritional support is required to reduce mortality in patients with severe acute pancreatitis.