Specific prognostic factors for secondary pancreatic infection in severe acute pancreatitis.
OBJECTIVE
The aim of the present study was to investigate whether there are specific prognostic factors to predict the development of secondary pancreatic infection (SPI) in severe acute pancreatitis in order to perform a computed tomography-fine needle aspiration with bacteriological sampling at the right moment and confirm the diagnosis.


METHODS
Twenty-five clinical and laboratory parameters were determined sequentially in 150 patients with severe acute pancreatitis (SAP) and univariate, and multivariate regression analyses were done looking for correlation with the development of SPI.


RESULTS
Only APACHE II score and C-reactive protein levels were related to the development of SPI in the multivariate analysis. A regression equation was designed using these two parameters, and empiric cut-off points defined the subgroup of patients at high risk of developing secondary pancreatic infection.


CONCLUSIONS
The results showed that it is possible to predict SPI during SAP allowing bacteriological confirmation and early treatment of this severe condition.
Armengol-Carrasco
M
M
Department of Surgery, University Hospital Vall d'Hebron, Barcelona, Spain.
Oller
B
B
Escudero
L E
LE
Roca
J
J
Gener
J
J
Rodríguez
N
N
del Moral
P
P
Moreno
P
P
D018806:APACHE; D000038:Abscess / Q000175:diagnosis*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001424:Bacterial Infections / Q000175:diagnosis* / Q000401:mortality; D001707:Biopsy, Needle; D002097:C-Reactive Protein / Q000032:analysis*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000175:diagnosis* / Q000401:mortality; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012044:Regression Analysis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate
D002097:C-Reactive Protein