| アブストラクト | BACKGROUND: Early intravenous crystalloid resuscitation is central to acute pancreatitis (AP) management; however, whether normal saline (NS) or balanced Ringer's solutions (RS) are superior for reducing mortality remains unsettled. METHODS: Using the Japanese Diagnosis Procedure Combination database (July 2010-March 2022), we identified adults admitted to general medical wards with AP who had a hospital stay longer than 3 days and received sufficient fluid resuscitation within three days of admission. Patients were classified by predominant crystalloid exposure during the first three days (NS vs. RS). Propensity score matching was used to balance measured confounders and compare in-hospital mortality and total hospitalization costs between the two groups. RESULTS: Among 43,247 eligible patients, 1,652 (4.0%) predominantly received NS and 41,595 (96.0%) predominantly received RS. Propensity score matching yielded 1,650 well-balanced pairs. In-hospital mortality was higher with NS than with RS (2.9% vs 1.8%; risk difference, 1.2%; 95% CI, 0.12% to 2.2%). NS was also associated with higher total hospitalization costs (difference, 1,344 USD; 95% CI, 725 to 1,963). CONCLUSIONS: In this nationwide cohort of adults with AP admitted to general medical wards, predominant early use of NS was associated with higher in-hospital mortality and higher hospitalization costs compared with RS. |
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| ジャーナル名 | Journal of gastroenterology |
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| Pubmed追加日 | 2026/7/23 |
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| 投稿者 | Okada, Haruka; Horibe, Masayasu; Sasabuchi, Yusuke; Bazerbachi, Fateh; Sato, Tsubasa; Matsuo, Yuichiro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Kanai, Takanori |
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| 組織名 | Division of Gastroenterology and Hepatology, Department of Internal Medicine,;School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-Ku, Tokyo,;160-8582, Japan.;160-8582, Japan. masayasu.horibe@gmail.com.;Department of Real-world Evidence, Graduate School of Medicine, The University of;Tokyo, Tokyo, Japan.;CentraCare, Interventional Endoscopy Program, St. Cloud Hospital, St. Cloud, MN,;USA.;Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota,;Minneapolis, MN, USA.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Institute of Science Tokyo Graduate;School, Tokyo, Japan.;160-8582, Japan. takagast@keio.jp. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42489684/ |
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