Indicators of cumulative nitrogen balance and energy in early period of acute pancreatitis are associated with form of disease and in-hospital mortality

Sivkov O.G.; Sivkov A.O.; Zaitsev E.Yu.; Leimanchenko I.A.; Sivkova E.O.

doi:https://doi.org/10.17116/anaesthesiology202601167

Sivkov O.G.

Yugra District Cardiology Dispensary «Center for Diagnosis and Cardiovascular Surgery»;
Surgut State University

ORCID: 0000-0002-7694-9293

Sivkov A.O.

Medical Sanitary Unit «Neftyanik»

ORCID: 0000-0003-3682-2789

Zaitsev E.Yu.

Medical Sanitary Unit «Neftyanik»

ORCID: 0000-0002-7685-1616

Leimanchenko I.A.

Medical Sanitary Unit «Neftyanik»

ORCID: 0009-0008-9474-9173

Sivkova E.O.

Medical Sanitary Unit «Neftyanik»

ORCID: 0009-0000-2440-7161

Indicators of cumulative nitrogen balance and energy in early period of acute pancreatitis are associated with form of disease and in-hospital mortality

Authors:

Sivkov O.G., Sivkov A.O., Zaitsev E.Yu., Leimanchenko I.A., Sivkova E.O.

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Journal: Russian Journal of Anesthesiology and Reanimatology. 2026;(1): 67‑75

DOI: 10.17116/anaesthesiology202601167

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To cite this article:

Sivkov OG, Sivkov AO, Zaitsev EYu, Leimanchenko IA, Sivkova EO. Indicators of cumulative nitrogen balance and energy in early period of acute pancreatitis are associated with form of disease and in-hospital mortality. Russian Journal of Anesthesiology and Reanimatology. 2026;(1):67‑75. (In Russ.)
https://doi.org/10.17116/anaesthesiology202601167

Использование инфографики авторами научных работ

OBJECTIVE

To evaluate cumulative nitrogen and energy balance within 5 days after admission as predictors of form of disease and in-hospital mortality in patients with acute pancreatitis (AP) undergoing early enteral nutrition.

MATERIAL AND METHODS

A prospective cohort single-center study included 64 patients with predictors of severe AP (APACHE II score >8, CRP>150 mg/L, SOFA score >2) who received early enteral nutrition for 5 days. Urinary nitrogen excretion was determined by urine urea, and nitrogen balance (NB) was subsequently calculated. Resting energy requirement (RER) was determined by indirect calorimetry (IC). Statistical analysis was performed using SPSS-26 software.

RESULTS

The following indicators can predict severe form of AP: NB (AUC 0.766, 95% CI 0.649—0.884; p<0.001, Se 0.710, Sp 0.667) with a cut-off threshold -86.4 g of nitrogen per 5 days, amount of nitrogen administered with enteral nutrition (AUC 0.822, 95% CI 0.716—0.928; p<0.001, Se 0.931, Sp 0.636) with a cut-off threshold of 23.24 g of nitrogen per 5 days and energy balance (AUC 0.818, 95% CI 0.713—0.922; p<0.001, Se 0.727, Sp 0.806) with a cut-off threshold 10105 kcal for 5 days. The most accurate model for in-hospital mortality was NB (AUC 0.832, 95% CI 0.722—0.962; p=0.0001, Se 0.600, Sp 0.891) with a cut-off threshold 8.6 g/nitrogen per 5 days, for patients with severe AP — nitrogen excretion with urine (AUC 0.741, 95% CI 0.667—0.875; p=0.043, Se 0.667, Sp 0.875) with a cut-off threshold 52.4 g/nitrogen for 5 days.

CONCLUSION

Indicators of cumulative nitrogen and energy balance within 5 days after admission in early period of acute pancreatitis with predicted severe course of disease and early enteral nutrition may be used as predictors of severe form of disease and in-hospital mortality. The best predictors of severe AP were cumulative (over 5 days) nitrogen, energy and nitrogen intake during this period. The best predictor of in-hospital mortality was nitrogen balance over 5 days, for patients with severe disease (n=33) — nitrogen excretion with urine over 5 days.

Keywords:

acute pancreatitis

nitrogen balance

tube feeding

predictor

Authors:

Sivkov O.G.

Yugra District Cardiology Dispensary «Center for Diagnosis and Cardiovascular Surgery»;
Surgut State University

ORCID: 0000-0002-7694-9293

Sivkov A.O.

Medical Sanitary Unit «Neftyanik»

ORCID: 0000-0003-3682-2789

Zaitsev E.Yu.

Medical Sanitary Unit «Neftyanik»

ORCID: 0000-0002-7685-1616

Leimanchenko I.A.

Medical Sanitary Unit «Neftyanik»

ORCID: 0009-0008-9474-9173

Sivkova E.O.

Medical Sanitary Unit «Neftyanik»

ORCID: 0009-0000-2440-7161

Received:

11.12.2024

Accepted:

12.06.2025

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References:

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