Risk of death from acute pancreatitis

Abstract

Seventeen (8.8%) patients died; mortality showed a decreasing trend over the period of years considered and was correlated, among other things, with necrotizing type of pancreatitis, idiopathic etiology, and shock status on admission.

Fatal Outcome in Acute Pancreatitis: Its Occurrence and Early Prediction

“…With 5% in our study, we are in this range [1][2][3][4][5][6][7][8][9]16] (table 5). Early mortality has been variously defined as death within 1 week [2-4] or 2 weeks [1,9], five studies having mentioned the exact time of death. With the exception of smaller studies [1,3], we -like others -show that about half of the patients die from acute pancreatitis early and half late, with the first half dying from multiple organ failure and the second from septic complications.…”

“…Early mortality has been variously defined as death within 1 week [2-4] or 2 weeks [1,9], five studies having mentioned the exact time of death. With the exception of smaller studies [1,3], we -like others -show that about half of the patients die from acute pancreatitis early and half late, with the first half dying from multiple organ failure and the second from septic complications. This agrees with a postmortem study showing that 60% of the patients died within one week because of multiple organ failure and 40% of infections later [17].…”

“…Despite all efforts to make an early diagnosis and start timely treatment of acute pancreatitis, mortality is still high, ranging between 2 and 9% in the latest studies [1][2][3][4][5][6][7][8][9]. It was the purpose of this study to establish early prognostic factors of death so as to improve treatment.…”

Has Blood Glucose Level Measured on Admission to Hospital in a Patient with Acute Pancreatitis Any Prognostic Value?

“…Heath and Imrie [7] challenged the results, showing that Fan's criteria, known as the Hong Kong criteria, had less predictive value for severity in acute pancreatitis than the Glasgow scores or clinical assessment after 48 h. Heath et al [8] confirmed, showing that the Hong Kong criteria had less predictive value than the Ranson, Glasgow and APACHE II scores. While these studies tested blood glucose on admission against general clinical or biochemical parameters of severity, Talamini et al [19] tested it against mortality. They found that serum glucose 1250 mg/dl (13.88 mmol/l) and a serum creatinine 12 mg/dl (176.8 Ìmol/l) were significant mortality factors.…”

Acute Pancreatitis in the Guangdong Province, China

“…However, this relatively low mortality rate should be treated with some caution: to start, these medical centers have a long history in the area of research and treatment of acute pancreatitis in Guangdong. On the other hand, there have been large numbers of studies addressing the issue of mortality in acute pancreatitis with various etiologies; in addition, it is said that biliary pancreatitis may have a self-limiting course, while alcoholic pancreatitis is more likely to develop into severe pancreatitis as compared with other etiologies, along with a higher mortality rate [14,15,16]. For this reason, it is of great importance to point out that the predominant etiology of severe acute pancreatitis in this study was biliary tract disease (nearly 50%) which may explain the relatively low mortality rate in severe acute pancreatitis to some extent, suggesting that course and outcome of severe acute pancreatitis are somewhat determined by the underlying etiology which could be further confirmed by multivariate analysis: the biliary etiology served as a protective factor against a poor clinical outcome in patients with severe acute pancreatitis.…”