Prevalence and risk factors of organ failure in patients with severe acute pancreatitis

Abstract

Abstract:

BACKGROUND: This study was undertaken to determine the prevalence of organ failure and its risk factors in patients with severe acute pancreatitis (SAP) .

METHODS: A retrospective analysis was made of 186 patients with SAP who were had been hospitalized in the intensive care unit of Jinzhong First People’s Hospital between March 2000 and October 2009. The patients met the diagnostic criteria of SAP set by the Surgical Society of the Chinese Medical Association in 2006. The variables collected included age, gender, etiology of SAP, the number of comorbidit, APACHEII score, contrast-enhanced CT (CECT) pancreatic necrosis, CT severity index (CTSI) , abdominal compartment syndrome (ACS) , the number of organ failure, and the number of death. The prevalence and mortality of organ failure were calculated. The variables were analyzed by unconditional multivariate logistic regression to determine the independent risk factors for organ failure in SAP.

RESULTS: Of 186 patients, 96 had organ failure. In the 96 patients, 47 died. There was a significant association among the prevalence of organ failure and age, the number of comorbidity, APACHEII score, CECT pancreatic necrosis, CTSI, and ACS. An increase in age, the number of comorbidity, APACHEII score, CECT pancreatic necrosis were correlated with increased number of organ failure. Age, the number of comorbidity, APACHEII score, CECT pancreatic necrosis, CTSI and ACS were assessed by unconditional multivariate logistic regression.

CONCLUSIONS: Organ failure occurred in 51.6% of the 186 patients with SAP. The mortality of SAP with organ failure was 49.0%. Age, the number of comorbidity, APACHEII score, CECT pancreatic necrosis, CTSI and ACS are independent risk factors of organ failure.

Key words: Severe acute pancreatitis, Organ failure, Prevalence, Risk factor, Age, Comorbidity, APACHE, Pancreatic necrosis, Abdominal compartment syndrome

Xiao-yan Li, Xiao-bo Wang, Xiu-feng Liu, Shu-gui Li. Prevalence and risk factors of organ failure in patients with severe acute pancreatitis[J]. World Journal of Emergency Medicine, 2010, 1(3): 201-204.

Figures/Tables 2

Table 1

Table 2

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Factors	Number of failed organs				P value
Factors	0 (n=90)	1 (n=39)	2 (n=35)	3 (n=22)	P value
Age (years)	48.7±14.9	52.5±15.7	53.4±15.1	61.8±14.2	<0.01
Gender					>0.05
M	50 (55.6%)	22 (56.4%)	19 (54.3%)	13 (59.1%)
F	40 (44.4%)	17 (43.6%)	16 (45.7%)	9 (40.9%)
Pathgen					>0.05
Biliary	39 (43.3%)	20 (51.3%)	19 (54.3%)	13 (59.1%)
Alcohol	27 (30.0%)	11 (28.2%)	10 (28.6%)	9 (40.9%)
Hyperlipemia	17 (18.9%)	8 (20.5%)	6 (17.1%)	0
Trauma	7 (7.8%)	0	0	0
Number of complcations					<0.001
0	50 (55.6%)	6 (15.4%)	6 (17.1%)	4 (18.2%)
1	32 (35.6%)	9 (23.1%)	8 (22.9%)	5 (22.7%)
2	8 (8.9%)	11 (28.2%)	10 (28.6%)	8 (36.4%)
3	0	13 (33.3%)	11 (31.4%)	5 (22.1%)
APACHEII	8.08±3.46	11.52±5.26	13.73±5.47	16.17±6.58	<0.001
CECT					<0.001
<30%	48 (53.3%)	6 (15.4%)	5 (14.3%)	1 (4.5%)
30%-50%	26 (28.9%)	12 (30.8%)	11 (31.4%)	2 (9.1%)
>50%	16 (17.8%)	21 (53.8%)	19 (54.3%)	19 (86.4%)
CTSI					<0.05
<7	57 (63.3%)	17 (43.6%)	12 (34.3%)	7 (31.8%)
≥7	33 (36.7%)	22 (56.4%)	23 (65.7%)	15 (68.2%)
ACS					<0.001
Yes	17 (18.9%)	24 (61.5%)	23 (65.7%)	16 (72.7%)
No	73 (81.1%)	15 (38.5%)	12 (34.3%)	6 (27.3%)
Number of deaths	14 (15.6%)	12 (30.8%)	18 (51.4%)	17 (77.3%)	<0.001

Factors	Regression coefficient β	mean±SD	P value	OR	95% CI (OR)
Age	0.500	0.168	0.005	1.648	1.149-2.338
Gender	0.245	0.534	0.639	1.278	0.453-3.641
Etiology	0.371	0.257	0.067	1.449	0.902-2.125
Number of complications	1.383	0.364	<0.001	3.986	1.857-7.589
APACHEII	0.810	0.143	<0.001	2.249	1.552-3.395
CECT	1.291	0.325	<0.001	3.635	1.904-6.404
CTSI	0.526	0.239	0.010	1.693	1.147-2.720
ACS	0.874	0.225	<0.001	2.396	1.614-3.657

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