IMPACT OF DEMOGRAPHIC VARIABLES ON THE RISK OF PANCREATOGENIC ENCEPHALOPATHY IN PATIENTS WITH NUTRITIONAL PANCREATONECROSIS

Abstract

Resume. Aim. Study of the dependence of the degree of risk of developing pancreatogenic encephalopathy (PEP) on demographic variables in patients with nutritional pancreatic necrosis. Materials and methods. A single-center prospective cohort non-randomized study was conducted on the basis of the Faculty Surgery Clinic of the Volgograd State Medical University in the period from 2010 to 2020. To determine the significance of the influence of a patient-dependent factor on the risk of developing PEP, ROC analysis was used. Logistic regression analysis was used to determine the degree of risk of developing PEP against the background of a combination of several covariates. Results. The study included 429 patients with pancreatic necrosis of alimentary origin. A comparative analysis of the incidence of PEP was carried out depending on gender and age, the trigger of the disease (alcohol-associated versus non-alcoholic pancreatic necrosis) and comorbid background. It has been proven that significant factors that increase the risk of developing PEP are age over 60 years (p = 0,04), alcohol-associated pancreatic necrosis (p < 0,001) and cardiovascular pathology - ischemic heart disease (p < 0,001). A statistically significant regression model of the effect of cardiovascular pathology on the incidence of PEP has been developed, which makes it possible to calculate the risk of this complication in a particular patient. Conclusions. Significant demographic variables that increase the risk of PEP include age over 60 years, alcoholic pancreatitis, and the presence of coronary artery disease in a patient. The developed logistic model makes it possible to calculate the personalized risk of PEP during hospitalization of a patient with nutritional pancreatic necrosis.