Correlative factor of death in patients with infected pancreatic necrosis after surgical intervention

Abstract

Background: Acute pancreatitis (AP) was a potentially fatal disease with a variation in severity. Infected pancreatic necrosis was a common complication in AP which needed surgical intervention. The present study was to study the correlative factors of death in patients with infected pancreatic necrosis after surgical intervention. Methods: From January 2016 to October 2019, a total of 186 patients with infected pancreatic necrosis after surgical intervention in the First Medical Center, Chinese PLA General Hospital were retrospectively enrolled in this study. Of the 186 patients, 22 who died in the hospital were defined as a mortality group and the others as a survival group. The clinical characteristic of the 2 groups was compared and the relative risk of mortality in patients with infected pancreatic necrosis after the surgical intervention was studied. Results: Acute fluid collection, acute kidney injury, acute lung injury, acute liver injury, multiple organ dysfunction syndromes, abdominal bleeding, abdominal Acinetobacter baumannii infection, pulmonary infection, pulmonary A baumannii infection, positive blood culture, A baumannii of blood culture, severe acute pancreatitis according to Atlanta 2012, the use of continuous renal replacement therapy, mechanical ventilation and minimally invasive retroperitoneal pancreatic necrosectomy was associated with death in hospital. Older age, longer acute kidney injury lasting time, longer acute lung injury lasting time, longer acute liver injury lasting time, and longer multiple organ dysfunction syndromes lasting time in predicting mortality in patients with infected pancreatic necrosis after surgical intervention were (0.635 [95% confidence interval (CI): 0.512–0.758], P = .040), (0.877 [95% CI: 0.788–0.965], P = .000], (0.932 [95% CI: 0.897–0.968], P = .000), (0.822 [95% CI: 0.708–0.935], P = .000), and (0.943 [95% CI: 0.887–0.998], P = .000). Due to the small number of death cases, the results of the multivariate analyses were not available. Conclusion: In this single-center retrospective study of 186 cases of infected pancreas necrosis, the correlative factors of death are identified. The results warranted further strategies are needed especially focusing on elder patients to prevent blood infection and to protect the functions of vital organs.