Predictors for mortality following acute pancreatitis in children.

Abstract

Although there are several studies focusing on pancreatitis etiology and clinical outcome, no previous report has examined the risk factors for death in children. We reviewed the medical records of all children (ages 0-18 years) admitted to West China Hospital with acute pancreatitis between 2002 and 2012. Independent predictors for death following acute pancreatitis in children were identified using a multivariate logistic regression analysis. Biliary diseases (23%), medications (20%), idiopathic (19%), and trauma (11%) were the most common etiologies for acute pancreatitis in children. The death rate was 5% and the mean duration of hospital stay was 13 days. Organ failure during admission occurred in 24 of 371 patients and most of them started in 3 days of onset (19/24). Multivariate analysis with logistic regression confirmed that occurrence of SIRS in the first week of onset (OR = 2.12, 95% CI 1.14-6.32, P < 0.001), occurrence of organ failure within 3 days of onset (OR = 8.0, 95% CI 2.2-12.3, P < 0.001), occurrence of MOF in the first week of onset (OR = 9.4, 95% CI 2.3-14.6, P < 0.001), infected necrosis (OR = 1.28, 95% CI 1.08-1.52, P = 0.02), and idiopathic cause (OR = 17.3, 95% CI 2.0-60.5, P < 0.001) were independent risk factors for death in cases with pancreatitis. Mortality rate and complication rate of acute pancreatitis in children remains low. Patients with SIRS, early organ failure, MOF, infected necrosis, or idiopathic cause should be well evaluated because they have higher risk of death.