ArticleWorld journal of emergency medicine2025
Association of fluid balance index with in-hospital mortality in critically ill patients with acute pancreatitis: a multicenter retrospective cohort study.
Article in World journal of emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Correlation between early cumulative fluid balance and 90-day all-cause mortality in patients with acute pancreatitis: a retrospective cohort study.Clinics (Sao Paulo, Brazil) · 2026Article
- Fluid resuscitation in the early management of acute pancreatitis: a five-year retrospective observational study.World journal of emergency medicine · 2026Article
- Protective role of local hypothermia in taurocholate-induced acute pancreatitis: anWorld journal of emergency medicine · 2026Article
- Association of fluid balance trajectories and cumulative fluid balance with in-hospital mortality in patients with acute pancreatitis.Frontiers in medicine · 2026Article
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Authors and funding
8 authors.
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Abstract
backgroundFluid resuscitation in acute pancreatitis (AP) patients requires precise titration because both excess and insufficient volumes may worsen outcomes. This study aimed to develop a weight-normalized fluid balance index (FBI) and assess its association with in-hospital mortality in critically ill AP patients.
methodsThis retrospective cohort study utilized data from the MIMIC-IV 3.0 database and the emergency intensive care unit (EICU) of our hospital (validation cohort) and was based on inclusion and exclusion criteria. Using the R package cutoff, an FBI of 145 mL/kg was identified as the optimal risk stratification threshold. The primary outcome was in-hospital all-cause mortality. Machine learning was used to screen covariates for inclusion in multivariable Cox models. Cox regression and restricted cubic spline (RCS) models were used to evaluate the relationship between FBI and mortality. Propensity score matching (PSM) was applied to minimize baseline confounding. After PSM, Kaplan-Meier survival curves were generated, and the results were validated via data from our center.
resultsIn this study, 547 AP patients from the MIMIC-IV database and 156 from the EICU of our hospital were included. In the MIMIC-IV cohort, the overall in-hospital mortality rate was 8.96%. Patients with FBI ≥145 mL/kg had significantly higher in-hospital mortality than did those with FBI <145 mL/kg (
conclusionAn FBI ≥145 mL/kg may be associated with increased in-hospital mortality in critically ill AP patients.
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