Evidence map›Paper›PMID 41024056›Full record

ArticleWorld journal of emergency surgery : WJES2025

Cumulative intra-abdominal pressure exposure and dynamic trajectories in ICU-admitted patients reveal prognostic determinants of severe acute pancreatitis.

Maobin Kuang, Yaoyu Zou, Shixuan Xiong, Cong He, Nianshuang Li, Ling Ding, Xueyang Li, Huijie Zhang, Yupeng Lei, Xin Huang and 7 more

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In one paragraph

Article in World journal of emergency surgery : WJES, 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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0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from it

What it found

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

17 authors.

Maobin KuangJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Yaoyu ZouJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Shixuan XiongJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Cong HeJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Nianshuang LiJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Ling DingJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Xueyang LiJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Huijie ZhangThe First Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China.
Yupeng LeiJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Xin HuangJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Huifang XiongJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Lingyu LuoJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Liang XiaJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Wenhua HeJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Nonghua LvJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China.
Jianhua WanJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China. ndyfy07545@ncu.edu.cn.
Yin ZhuJiangxi Provincial Key Laboratory of Digestive Diseases, Department of Gastroenterology, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, 330006, Jiangxi, China. ndyfy01977@ncu.edu.cn.

Funding

Double-Thousand Plan of Jiangxi Province jxsc2019201028Jiangxi Medicine Academy of Nutrition and Health Management 2022-PYXM-01Jiangxi Provincial Natural Science Foundation 20242BAB25438National Natural Science Foundation of China 82370661Project for academic and Technical Leaders of Major Disciplines in Jiangxi Province 20243BCE51144Science And Technology Innovation Team Cultivation Project of the First Affiliated Hospital of Nanchang University YFYKCTDPY202202
6 · The paper itself

Abstract

backgroundIntra-abdominal pressure (IAP) critically drives organ failure progression in severe acute pancreatitis (SAP). However, traditional static IAP monitoring inadequately captures dynamic injury evolution. This study aimed to assess the impact of cumulative IAP exposure (CumIAP) and dynamic trajectories on the prognosis of SAP.

methodsThis retrospective cohort study analyzed 1,008 ICU-admitted SAP patients from the Jiangxi cohort (2005-2023) and 83 from MIMIC-IV (2008-2019). CumIAP was quantified via time-weighted integration of serial IAP measurements. Multivariate Cox regression models and restricted cubic splines (RCS) were established to analyze the dose-response relationships between CumIAP and death, infectious pancreatic necrosis (IPN), and persistent multiple organ failure (PMOF). Mediation analysis evaluated CumIAP's role in albumin (ALB)- and acute necrotic collection (ANC)-associated outcomes. Latent class growth mixture model (LCGMM) was employed to identify dynamic IAP trajectory subtypes, and the associations between each trajectory group and poor prognosis were analyzed.

resultsOver a median inpatient follow-up of 17 days in the Jiangxi cohort, 200 (19.8%) patients died in hospital, while 208 (20.6%) and 329 (32.6%) developed IPN and PMOF, respectively. Regression analysis revealed that for each standard deviation increase in CumIAP, the risks of in-hospital death and PMOF increased by 37% and 86%, respectively, and there was a U-shaped association with the risk of IPN (P for nonlinearity = 0.004). Mediation analysis showed that CumIAP mediated 24.26% and 33.76% of the associations between ALB, ANC, and the risk of in-hospital death, respectively. Three IAP trajectories were identified by LCGMM: the high-pressure rapid decline group (HRD-T1), the low-pressure gradual decline group (LGD-T2), and the low-pressure progressive increase group (LPI-T3). Among them, compared with HRD-T1 and LGD-T2, the subjects in the LPI-T3 group had a significantly increased risk of adverse clinical outcomes.

conclusionThis is the first study to revealed that CumIAP is linearly positively correlated with death and PMOF, while exhibits a U-shaped relationship with IPN. Notably, patients with low baseline IAP and a rising trajectory exhibited worse outcomes than those with high baseline IAP and a declining trend.

Indexed as

Intra-Abdominal HypertensionPancreatitisPressureAdultAgedCohort StudiesFemaleHumansIntensive Care UnitsMaleMiddle AgedPrognosisRetrospective StudiesCumIAPCumulative exposureIAP trajectoryIntra-abdominal pressureLCGMMSAP

Identifiers

PMID41024056
PMCPMC12481794

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