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Clinical characteristics and prognostic factors of severe acute pancreatitis

Introduction

The aim of this study was to investigate the clinical characteristics and prognostic factors of a consecutive series of patients with severe acute pancreatitis (SAP). SAP is characterized by high morbidity and mortality.

Methods

Clinical data of SAP patients admitted to our hospital from January 2006 to January 2008 were retrospectively reviewed. Collected data included the age, gender, etiology, length of hospitalization, APACHE II score at admission, local and organ/systemic complications of the patients.

Results

Of the 125 acute pancreatitis patients, 42 developed SAP [1]. The mean age of SAP patients was 57 years, male/female 22/20 patients, the commonest etiology was cholelitiasis (43.5%), the mean length of hospitalization was 60 days, the mean score of APACHE II was 8.1. Fifty-seven percent of the patients developed necrosis, 23% abscessus, 11% pseudocyst. Fifty-eight percent developed organ/systemic failure. A total of 25.2% (11/42) of the SAP patients died. Respiratory failure was the most common organ dysfunction (90.0%) in deceased SAP patients, follow by cardiovascular failure (86.4%), and renal failure (50.0%). In the SAP patients, 90.9% (9/11) developed multiple organ/systemic failures. There were significant differences in age, length of hospitalization, APACHE II score and incidences of respiratory failure, cardiovascular failure, renal failure between deceased SAP patients and surviving SAP patients [2]. By multivariate logistic regression analysis, the independent prognostic factors for mortality were respiratory failure, cardiovascular failure and renal failure.

Conclusion

SAP patients are characterized by advanced age, high APACHE II score and organ failure, and their death is mainly due to multiple organ/systemic failures. In patients with SAP, respiratory, cardiovascular and renal failure can predict the fatal outcome and more attention must be paid to their clinical evaluation.

References

  1. 1.

    Isenman R, et al.: Early severe acute pancreatitis. Pancreas 2001, 22: 274-278. 10.1097/00006676-200104000-00008

  2. 2.

    Company L, et al.: Factors predicting mortality in severe acute pancreatitis. Pancreatology 2003, 3: 144-148. 10.1159/000070083

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Kostadinovska, B., Sosolceva, M. Clinical characteristics and prognostic factors of severe acute pancreatitis. Crit Care 13, P501 (2009). https://doi.org/10.1186/cc7665

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Keywords

  • Prognostic Factor
  • Pancreatitis
  • Renal Failure
  • Respiratory Failure
  • Acute Pancreatitis