PANCREAS ALERTS
Pancreas 2000; 21:266-71
Halonen KI, Leppaniemi AK, Puolakkainen PA, Lundin JE, Kemppainen EA, Hietaranta AJ, Haapiainen RK.
Department of Surgery, Helsinki University Central Hospital, Huch, Finland.
The aim of this study which was carried out at the Helsinki University Central Hospital in Finland, was to analyse a large consecutive series of patients with severe acute pancreatitis and to identify prognostic factors for hospital mortality.
A consecutive series of 270 patients observed between 1989 and 1997 were recruited. All patients fulfilled the criteria of the Atlanta classification for severe AP. Various clinical and biochemical data restrospectively and prospectively collected were considered.
The overall mortality rate was 24.4%. In univariate survival analysis, advanced age, history of continuous medication, transfers from other hospitals, high body mass index, respiratory or renal failure, need for pressor support and need for abdominal surgery were significant prognostic factors for hospital mortality. In multivariate analysis, the need of pressor support, renal failure requiring dialysis, advanced age, history of continuous medication and the need for abdominal surgery were identified as independent prognostic factors for mortality.
Int J Pancreatol 2000; 28:91-5
Mutinga M, Rosenbluth A, Tenner SM, Odze RR, Sica GT, Banks PA.
Center for Pancreatic Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (USA).
The aim of this study carried out at Brigham and Women's Hospital of Boston, USA, was to determine the timing of mortality in acute pancreatitis.
The medical charts and/or computerized medical records of 805 patients suffering from acute pancreatitis observed over 14 years (1982-1995) were retrospectively analyzed.
The overall mortality was 2.1 percent (17 patients); eight deaths (47 %) occurred within the first 14 days of hospitalization (median day 8, range 1-11), whereas 9 occurred after day 14 (median 56 days, range 19-81). Early deaths resulted primarily from organ failure; the later deaths occurred post-operatively in 8 patients with infected or sterile necrosis and 1 patient with infected necrosis who was treated medically.
The Authors concluded that improvement in mortality of severe acute pancreatitis will require innovative approaches to counteract early organ failure and eventual complications of the disease.