{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:03:46Z","timestamp":1784783026363,"version":"3.55.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004608","name":"Natural Science Foundation of Jiangsu Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004608","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to investigate whether neutrophil elastase inhibitor (sivelestat sodium) was associated with decreased duration of organ failure in patients with acute pancreatitis (AP) and early organ failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between January 2022 and December 2024, patients who were diagnosed with AP and early organ failure were included. The primary outcome was organ failure-free days (OFFD) to Day 14 after admission. Propensity score matching (PSM) analysis was performed to control confounders. Multivariate zero-inflated negative binomial regression model was used to evaluate the association between sivelestat sodium and OFFD. An exploratory mediation analysis was carried out to evaluate whether day 3 C-reactive protein partly accounted for the association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      340 patients were enrolled in this study. After PSM, patients receiving sivelestat sodium had significantly more OFFD than those who did not (median [IQR], 9 [5 to 13] vs. 6 [1 to 10],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.040). Using sivelestat sodium was associated with increased OFFD (Incidence rate ratio = 1.21,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001) after adjusting for covariates. The exploratory mediation analysis suggested that this association was primarily direct (1.28 days,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.036), with a marginally significant component mediated through day 3 C-reactive protein reduction (0.13 days,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.068).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sivelestat sodium use was associated with more organ failure-free days in patients with AP and early organ failure, particularly in those with respiratory failure. These findings require confirmation in future prospective randomized trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1840457","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:33:42Z","timestamp":1784781222000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The use of sivelestat sodium among patients with acute pancreatitis and early organ failure: a single-center retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Zongwen","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Center of Severe Acute Pancreatitis (CSAP), Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinsen","family":"Zou","sequence":"additional","affiliation":[{"name":"Department 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Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, School of Medicine, Center of Severe Acute Pancreatitis (CSAP), Southeast University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Center of Severe Acute Pancreatitis (CSAP), Jinling Hospital, Nanjing Medical University, Nanjing","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Center of Severe Acute Pancreatitis (CSAP), Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjian","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Center of Severe Acute Pancreatitis (CSAP), Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing","place":["Jiangsu, China"]},{"name":"National Institute of Healthcare Data Science, Nanjing University, Nanjing","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, The Affiliated Huai\u2019an No.1 People\u2019s Hospital of Nanjing Medical University, Huai\u2019an","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangcheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, The Affiliated Huai\u2019an No.1 People\u2019s 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