Pancreatitis

Notes: Tabone, Lawrence E

Conlon, Molly

Fernando, Emil

Yi, Sophia

Sarker, Sharfi

Fisichella, P Marco

Luchette, Fred A

eng

Comparative Study

2013/05/02 06:00

Am J Surg. 2013 Oct;206(4):472-7. doi: 10.1016/j.amjsurg.2012.12.009. Epub 2013 Apr 28.

URL: http://www.ncbi.nlm.nih.gov/pubmed/23631907

Author Address: Department of Surgery, Stritch School of Medicine, Loyola University of Chicago, 2160 South First Avenue, Maywood, IL 60153, USA; Stritch School of Medicine, Loyola University of Chicago, Maywood, IL, USA.

 

 

Reference Type:  Journal Article

Record Number: 5170Author: Thandassery, R. B., Yadav, T. D., Dutta, U., Appasani, S., Singh, K. and Kochhar, R.

Year: 2013

Title: Dynamic nature of organ failure in severe acute pancreatitis: the impact of persistent and deteriorating organ failure

Journal: HPB (Oxford)

Volume: 15

Issue: 7

Pages: 523-8

Date: Jul

Short Title: Dynamic nature of organ failure in severe acute pancreatitis: the impact of persistent and deteriorating organ failure

Alternate Journal: HPB : the official journal of the International Hepato Pancreato Biliary Association

ISSN: 1477-2574 (Electronic)

1365-182X (Linking)

DOI: 10.1111/j.1477-2574.2012.00613.x

PMCID: 3692022

Accession Number: 23750495

Keywords: Apache

Adult

Bacterial Infections/etiology

Chi-Square Distribution

Disease Progression

Drainage

Female

Glasgow Coma Scale

Hospitalization

Humans

Kaplan-Meier Estimate

Male

Middle Aged

Multiple Organ Failure/diagnosis/*etiology/mortality/therapy

Odds Ratio

Organ Dysfunction Scores

Pancreatitis, Acute Necrotizing/*complications/diagnosis/mortality/therapy

Prognosis

Prospective Studies

Risk Factors

Severity of Illness Index

Time Factors

Abstract: BACKGROUND AND AIMS: In acute pancreatitis (AP), patients with persistent organ failure [POF, duration of organ failure (OF) >/=48 h] and transient organ failure (TOF, duration of OF <48 h) have different outcomes. We have compared the clinical course and outcome of patients with severe AP (SAP) with TOF and POF in the first week of hospitalization as well as the impact of change in the OF score in the first week on patient outcome. METHODS: Consecutive patients with SAP were evaluated for OF and its dynamics during the first week of hospitalization. The modified multiple organ failure score (MOFS) was used to identify OF, grade its severity and monitor its progression. The clinical course and outcome of patients were studied. RESULTS: Of 114 patients, mean age 39.2 +/- 13.7 years, 37 (32.5%) patients had no OF, 34 (29.8%) had TOF and 43(37.7%) had POF. Patients with POF had the higher infected necrosis, increased requirement for percutaneous drain placement, surgery and higher mortality as compared with those with TOF. The odds ratio for mortality with persistent and deteriorating OF was 26.2 [confidence interval (CI) 5.1-134.9] compared with only persistent OF. CONCLUSION: The dynamics of OF in the first week of SAP predicts the clinical course and outcome. Persistent and deteriorating OF indicates a poor outcome.

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