ArticleInternational journal of surgery (London, England)2026
Cumulative burden and dynamic trajectories of heart rate as predictors of prognosis in acute pancreatitis: an 18-year cohort study.
Article in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Prognostic significance of heart rate trajectories on organ failure in predicted severe acute pancreatitis: secondary analysis of a randomized trial.Scientific reports · 2026Trial
- Cumulative stress hyperglycemia ratio exposure and dynamic trajectories reveal prognostic determinants of acute hyperlipidemic pancreatitis: an 5-year cohort study.Lipids in health and disease · 2026Article
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8 authors.
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Abstract
backgroundTachycardia is common in early severe acute pancreatitis (SAP), yet prior studies lack dynamic progression modeling. This study evaluated cumulative heart rate (CumHR) and dynamic trajectories as predictors of prognosis in acute pancreatitis (AP).
methodsA retrospective cohort of 5393 AP patients (admitted ≤3 days postonset, 2005-2023) was analyzed. CumHR was calculated using heart rate (HR) data from the first 7 days postadmission. Latent class trajectory modeling (LCTM) identified dynamic patterns. Multivariable regression, restricted cubic spline (RCS) analyses, and ROC curves assessed associations and predictive performance.
resultsCumHR outperformed single-timepoint HR measurements in discriminating mortality, SAP, infectious pancreatic necrosis (IPN), and persistent multiple organ failure (PMOF). Each 1-SD increase in CumHR elevated mortality risk (OR = 2.81, 95% CI:2.29-3.45). U-shaped dose-response relationships with mortality/SAP/PMOF (inflection at CumHR ≈ 500) and linear association with IPN were observed. CumHR achieved 87.1% AUC (95% CI:84.2-89.9%) for mortality prediction, exceeding daily HR metrics. LCTM stratified five trajectories; the persistently elevated group (SLG-T5) had the highest mortality (20.6% vs. 0.2% in SHG-T1).
conclusionsCumHR and dynamic trajectories independently predict AP prognosis. Persistently elevated HRs (SLG-T5) necessitate early intervention, while CumHR > 500 may guide high-risk stratification.
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