Analysis of clinical features and prognosis in sports and athletic patients with severe acute pancreatitis complicated by acute kidney injury

Abstract

Objectives: This study aims to investigate the clinical characteristics and prognosis of severe acute pancreatitis (SAP) with acute kidney injury (AKI) specifically in sports and athletic patients, identifying the unique risk factors influencing renal function and overall prognosis within this demographic. Methods: A retrospective analysis was conducted on SAP patients with a history of athletic or sports activity, treated in our hospital from September 2017 to September 2020. Among 200 eligible patients, 60 were diagnosed with AKI (AKI group) and 140 without AKI (non-AKI group). We compared the clinical features and prognosis between these groups and utilized logistic regression to identify risk factors impacting renal function and prognosis. Results: The study included 200 SAP patients, with 115 males (57.5%) and 85 females (42.5%), reflecting the typical gender distribution in sports and athletic populations. The average age was 50.15±15.32 years, highlighting a middle-aged athletic demographic. The average hospital stay was 21.36±14.14 days. High lipidemia, often associated with dietary habits in athletes, was the leading cause of pancreatitis (52.5%), followed by biliary issues (33.5%). The AKI group had a significantly older average age than the non-AKI group (51.32±13.54 years vs. 38.31±11.3 years), suggesting age as a potential risk factor in athletes. Despite no statistical difference in gender or pancreatitis etiology, significant differences were noted in age, blood pressure, treatment plans, and outcomes (P<0.05), with the AKI group showing poorer prognosis. Laboratory comparisons revealed significant differences in inflammation markers (CRP, PCT) and renal function tests (UA, γ-GT, APTT), which are crucial in athletes due to their potential for rapid physiological changes. Multifactorial logistic regression identified systolic blood pressure as a protective factor, while elevated PCT, CRP, UA, γ-GT, and APTT were independent risk factors for AKI in SAP patients. Specifically, APTT and Marshall scores were independent risk factors for mortality in SAP patients with AKI. Conclusions: For sports and athletic patients, APTT and Marshall scores are significant predictors of mortality in SAP with AKI. The study underscores the importance of meticulous monitoring of organ function, strict control of blood lipids, and proactive infection management in this unique patient population, emphasizing tailored approaches to prevention and treatment strategies in athletes.