Abstract
Prospective cohort study of 113 patients with necrotizing pancreatitis who were admitted to single intensive care department has been performed. Persistent organ failure was diagnosed in 50 (44 %) and transient – in 63 (56 %) cases. Death occurred in 31 (27,4 %) patients: 28 (56 %) with persistent and 3 (4,8 %) with transient organ failure and system complications. Respiratory failure (67 %) dominated in the mortality structure, cardio-vascular (59 %), renal (56 %) and intestinal (54 %) failures occurred with an equal frequency. Bedside Index for Severity in Acute Pancreatitis (BISAP) score allowed making a high probability prognosis of organ failure and mortality in patients with acute necrotizing pancreatitis at admission.
Highlights
An increasing incidence of acute pancreatitis has been reported recently, with an estimated 21000 new cases per year in the United States [4]
Intensive therapy, which included rigorous fluids resuscitation, hemodynamic and respiratory support, was ineffective in 17 patients, who died at the early phase of acute necrotizing pancreatitis due to pancreatic shock caused by multiple organ failure
Multivariate logistic regression analysis revealed that the number of organs in multiple organ failure was the main prognostic factor of death in patients with acute necrotizing pancreatitis (p
Summary
An increasing incidence of acute pancreatitis has been reported recently, with an estimated 21000 new cases per year in the United States [4]. Assessment of the severity of the attack and predicting the course of the disease are important when determining the allocation of care for these patients or the need for transfer to a higher level care early in the disease process. Recent researches have established that the presence of multiorgan failure alongside with pancreatic infection are major determinants of mortality during acute necrotizing pancreatitis [8, 11]. Different extents of pancreatic necrosis and its subsequent complications may contribute to the occurrence of organ failure and mortality during the admission period [9]. The initial determination of severity in acute necrotizing pancreatitis to evaluate organ failure and the complications of pancreatic necrosis as soon as possible is critical for the appropriate management and risk assessment in a clinical setting
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