Abstract
Background
Patients with critical acute pancreatitis (CAP) have the highest risk of mortality.
However, there have been no studies specifically designed to evaluate the prognostic
factors of CAP.
Aims & methods
This was a prospective observational cohort study involving patients with CAP. Three
aspects including organ failure, (peri)pancreatic necrotic fluid cultures and surgical
interventions were analyzed specifically to identify prognostic factors.
Results
Of the 102 consecutive patients with CAP, 83 patients (81.4%) received step-up surgical
treatment, the mortality of the step-up group was 25.3% (21/83). 19 patients (18.6%)
underwent step-down surgical treatment, the mortality of the step-down group was 57.9%
(11/19). Overall mortality in the whole cohort was 31.4% (32/102). Multivariate analysis
of death predictors indicated that multiple organ failure (MOF) (OR = 5.3; 95% CI,
1.5–18.2; p = 0.008), long duration (≥5 days) of organ failure (OR = 6.4; 95% CI, 1.2–54.3; p = 0.029), multidrug-resistant organisms (MDROs) infection (OR = 4.6; 95% CI, 1.3–15.8;
p = 0.013), OPN (OR = 3.7; 95% CI, 1.5–8.8; p = 0.004) and step-down surgical treatment (OR = 3.5; 95% CI, 1.2–10.1; p = 0.019) were significant factors.
Conclusion
Among patients with CAP, MOF, long duration (≥5 days) of organ failure, MDROs infection,
OPN and step-down surgical treatment were identified as the predictors of mortality.
Keywords
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Article info
Publication history
Published online: May 09, 2019
Accepted:
April 5,
2019
Received:
January 20,
2019
Identification
Copyright
© 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
