Épidémiologie, pronostic et complications infectieuses nosocomiales des pancréatites aiguës graves en réanimation : étude prospective multicentrique à partir de la base de données CClin Sud-Est

Abstract

ObjectivesTo describe the demographic characteristics, incidence of extra-abdominal hospital-acquired infections and outcome of patients admitted to intensive care unit (ICU) with severe acute pancreatitis. Study designA retrospective, observational multiple center (65 centers) analysis of prospectively acquired data. Patients and methodsDuring 2 years, all consecutive admitted patients to ICU for severe acute pancreatitis in the centers participating in the nosocomial infections surveillance network CClin Sud-Est were included. Patients whose ICU stay was less than 48hours were not included. Demographic characteristics, extra-abdominal hospital-acquired infections and clinical course were described. ResultsDuring the study period, 510 patients were included which represented 2 % of patients with a length of stay longer than 48hours in the 65 participating ICUs. The global attack rate of extra-abdominal hospital-acquired infections (pneumonia, bacteremia, urinary tract or central venous catheter infection) was 23 % in overall patients and it was 33 % in the 294 mechanically ventilated patients. ICU mortality was 20 % in overall patients and it was 34 % in mechanically ventilated patients. ConclusionSevere acute pancreatitis represents 2 % of ICU stay longer than 48hours. Its clinical course is frequently complicated by hospital-acquired infections and is associated with an high ICU mortality rate. This epidemiological observational study may be used for calculating sample size for future multicenter interventional therapeutic studies.