title: An audit of fatal acute pancreatitis.
abstract: Acute pancreatitis has a mortality of about 10%: this figure has not changed over the last 20 years. A retrospective audit of fatal acute pancreatitis was performed in a teaching hospital with a catchment population of about 750,000 patients to examine patient characteristics. Using Hospital Activity Analysis code 577.0, all fatal cases of acute pancreatitis were studied in a six-year period 1987-93. Additionally, all post mortem diagnoses of acute pancreatitis were traced. The overall post mortem rate in Nottingham at the time of the study was about 35%. All available records, X-ray and biochemical data were studied and appropriate information recorded and analysed for 65 fatal cases. Only 15% were post mortem diagnoses, lower than in previous series; 72% had respiratory and 67% had renal complications. Only 34% had been admitted to the intensive care unit. A third of patients had had surgery; 67% of these was some form of external drainage. Of the 14 patients with proven gallstone pancreatitis only three had endoscopic retrograde cholangiopancreatography; 42% of patients had idiopathic disease. Not all the patients diagnosed ante mortem had the full biochemical predicted severity criteria analysed: pO2 and calcium analysis was performed in about 80%. Pre-mortem diagnoses of pancreatitis was achieved more frequently than in other comparable series.
authors.affiliation: Department of Surgery, Queen's Medical Centre, Nottingham, UK.
authors.forename: A K
authors.initials: AK
authors.lastname: Banerjee
authors.forename: A
authors.initials: A
authors.lastname: Kaul
authors.forename: E
authors.initials: E
authors.lastname: Bache
authors.forename: A C
authors.initials: AC
authors.lastname: Parberry
authors.forename: J
authors.initials: J
authors.lastname: Doran
authors.forename: M L
authors.initials: ML
authors.lastname: Nicholson
mesh_terms: D000208:Acute Disease; D002423:Cause of Death; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D010043:Outcome and Process Assessment, Health Care; D010195:Pancreatitis / Q000150:complications / Q000401:mortality*; D012189:Retrospective Studies