Is Severity of Necrotizing Pancreatitis Increased in Extended Necrosis and Infected Necrosis?

Abstract

Although severity of necrotizing pancreatitis was somewhat increased in extended pancreatic necrosis and infected necrosis, mortality was more strongly linked to organ failure at admission and multiple organ failure during hospitalization.

Practice Guidelines in Acute Pancreatitis

“…Approximately 10% of patients with interstitial pancreatitis experience organ failure, but in the majority it is transient with a very low mortality. Median prevalence of organ failure in necrotizing pancreatitis is 54% (range 29-78%) (31,50,54,82,83,120,147,148). Prevalence of organ failure is the same or somewhat higher in infected necrosis (34-89%) than in sterile necrosis (45-73%) (66,83,138,161).…”

“…The mortality in the absence of organ failure is 0 (50,66,68,83), with single organ failure is 3% (range 0-8%) (66,83,163), with multisystem organ failure 47% (range 28-69%) (48,66,68,83,120,163,164).…”

“…Overall, 85% of patients have interstitial pancreatitis; 15% (range 4-47%) have necrotizing pancreatitis (25,44,46,50,68,83,86,128,140,169). Among patients with necrotizing pancreatitis, 33% (range 16-47%) have infected necrosis (62,66,68,83,91,111,113,117,118,120,121,147,159,169,170).…”

“…Several reports have pointed out that patients with organ failure at admission have a higher mortality than those who do not experience organ failure at admission (50,61,69,71,72,83,163). The progression of single organ failure to multisystem organ failure is a major determinant in the high mortality associated with organ failure at admission (83).…”

“…The progression of single organ failure to multisystem organ failure is a major determinant in the high mortality associated with organ failure at admission (83). Survival among patients with organ failure at admission has also been shown to correlate with the duration of organ failure (71,72,151).…”