Are the current diagnostic criteria for acute cholangitis applicable in patient with acute biliary pancreatitis?

Abstract

s / Pancreatology 15 (2015) S1eS141 S58 Aims: This study aims to further specify the impact of the type and timing of organ failure on mortality and the association with infected pancreatic necrosis. Patients & methods: We performed a post-hoc analysis of a prospective database of 639 consecutive patients with acute necrotizing pancreatitis from 21 hospitals. During the entire hospital stay, alle details regarding organ failure (i.e. respiratory, cardiovascular and renal) were collected. Results: In total, 240 of 639 patients with necrotizing pancreatitis (38%) developed organ failure. Mortality in 106 patients with renal failure was 47%, in 197 patient with cardiovascular failure 40%, and in 221 patients with respiratory failure 37%. Mortality was not related to the onset (first, second week or later) of persistent organ failure (41%, 43% and 32% respectively, P1⁄40.51). Mortality was not related to the duration of multiple organ failure lasting less than 1 week, 1 to 2 weeks, 2 to 3 weeks or longer than 3 weeks (43%, 38%, 46% and 52% respectively, P1⁄40.68). Persistent simultaneous failure of all 3 organ systems occurred in 52 patients with 63% mortality. Overall, patients with organ failure alone had a higher risk for mortality (44% of 108 patients) than patients with organ failure and infected necrosis (29% of 132 patients) (RR 2.6; 95% CI: 1.7-4.0; P<0.001). Conclusion: Organ failure, rather than infected necrosis, determines mortality in necrotizing pancreatitis. However, mortality was not related tot the onset and duration of organ failure.