Pancreas - Abstract: Volume 38(2) March 2009 p 122-125 Severe Acute Pancreatitis: Overall and Early Versus Late Mortality in Intensive Care Units.

http://www.pancreasjournal.com/pt/re/pancreas/abstract.00006676-200903000-00003.htm;jsessionid=Jj3BN1zc3q86bqzynjYNl7Wqnlh9ZVfpJcFpsZWfJSRVTvS315Tj!-858031623!181195628!8091!-1
Pancreas:Volume 38(2)March 2009pp 122-125
Severe Acute Pancreatitis: Overall and Early Versus Late Mortality in Intensive Care Units

Abstract

Objectives: To determine overall mortality and timing of death in patients with severe acute pancreatitis and factors affecting mortality.

Methods: This was a retrospective, observational study of 110 patients admitted to a general intensive care unit (ICU) from January 2003 to January 2006.

Results: The overall mortality rate was 53.6% (59/110); 25.4% (n = 15) of deaths were early (≤14 days after ICU admission). There were no significant differences in age, sex, or surgical/medical treatment between survivors and nonsurvivors. Median Acute Physiology and Chronic Health Evaluation (APACHE) II score was higher among nonsurvivors than survivors (score = 26 vs 19, respectively; P < 0.001), and the duration of hospitalization before ICU admission was significantly longer (4 vs 1 day; P < 0.001). Among the 59 patients who died, those in the early-mortality group were admitted to the ICU significantly earlier than those in the late-mortality group (3 vs 6.5 days; P < 0.05).

Conclusions: Overall mortality and median APACHE II score were high. Death predominantly occurred late and was unaffected by patient age, length of stay in the ICU, or surgical/medical treatment. An APACHE II cutoff of 24.5 and pre-ICU admission time of 2.5 days were sensitive predictors of fatal outcome.
© 2009 Lippincott Williams & Wilkins, Inc.

[Original Articles]

Bumbasirevic, Vesna MD, PhD*; Radenkovic, Dejan MD, PhD*; Jankovic, Zorica MD, PhD†; Karamarkovic, Aleksandar MD, PhD*; Jovanovic, Bojan MD*; Milic, Natasa MD, PhD‡; Palibrk, Ivan MD, PhD*; Ivancevic, Nenad MD, PhD*

From the *Clinical Center of Serbia, Belgrade, Serbia; †St James's University Hospital, Leeds, UK; and‡Institute for Medical Statistics and Informatics, Belgrade University School of Medicine, Belgrade, Serbia.

Received for publication September 8, 2007; accepted June 25, 2008.

Reprints: Zorica Jankovic, MD, PhD, St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK (e-mail: Zorica.Jankovic@leedsth.nhs.uk).