Abstract
OBJECTIVE: Serum uric acid/creatinine (SUA/Cr) can reflect the metabolic status of the body. However, the effect of SUA/Cr on the prognosis of severe acute pancreatitis (SAP) patients is not clear. This study aimed to investigate the impact of SUA/Cr on in-hospital mortality in SAP patients. METHODS: This study was a retrospective study involving 224 SAP patients admitted to the ICU of Fujian Medical University Union Hospital from January 2020 to April 2024. The primary outcome for patient inclusion was in-hospital mortality, and the secondary outcome include acute kidney injury (AKI), liver dysfunction, sepsis, septic shock, hemorrhagic shock, bacteremia, septicemia, respiratory failure, multiple organ dysfunction syndrome (MODS), etc. The data on serum uric acid and serum creatinine were extracted from the electronic medical record system. Data analysis was performed using SPSS 26.0 software. Receiver operating characteristic (ROC) curve analysis was employed to determine the cutoff value of SUA/Cr. Multivariate logistic regression analysis was conducted to assess the association between SUA/Cr and in-hospital mortality in SAP patients. RESULTS: A total of the 224 SAP patients included in the study, 88 (39.3%) had low SUA/Cr, while 136 (61.7%) had high SUA/Cr. There were statistically significant differences between the two groups in survival, AKI, sepsis, septic shock, septicemia, MODS, ICU days, and length of hospital stay (P < 0.001). Models I, II and III of in-hospital mortality in SAP patients adjusted for age, body mass index (BMI), sex, diabetes mellitus and nonalcoholic fatty liver disease, respectively. The results of model I showed that the OR of SUA was 1.002 (P = 0.601), and SCR was 1.009 (P = 0.027). In Model II, compared with the high SUA/Cr group, the OR of the low group was 8.027 (95%CI:1.447-14.511, P = 0.017). In Model III, SUA/Cr OR was 0.456 (95%CI: 0.239-0.872, P = 0.018). Meanwhile, age, BMI, APACHE-II scores, and mechanical ventilation were independent risk factors for death in SAP patients. CONCLUSION: This study indicated that SAP patients in the low SUA/Cr group have worse prognosis and higher in-hospital mortality, and low SUA/Cr is independently associated with increased in-hospital mortality. SUA/Cr may serve as a prognostic biomarker for SAP patients.