Analysis and prevention of factors predisposing to infections associated with severe acute pancreatitis.
OBJECTIVE
To analyze factors predisposing to the infections associated with severe acute pancreatitis (SAP) and work out ways for their prevention.


METHODS
208 patients with SAP treated at our hospital from January 1986 to December 2001 were retrospectively analyzed.


RESULTS
Statistical difference in the incidence of the infections was found between the following pairs: the groups of bloody or non-bloody ascites, paralytic ileus lasting shorter or longer than 5 days, Ranson's scores lower or higher than 5, hematocrit lower or higher than 45%, CT Balthazar scores lower or higher than 7, and between January 1986-June 1992 or July 1992-December 2001 admissions (chi2>7.58, P<0.05), while no statistical difference established between the groups of biliogenic and non-biliogenic pancreatitis, serum amylase <200 U/L and >/=200 U/L, serum calcium <2 mmol/L and >/=2 mmol/L or groups of total parenteral nutrition shorter or longer than 7 days (chi2<1.61, P>0.05).


CONCLUSIONS
Occurrence of infection in patients with SAP is closely related with bloody ascites, paralytic ileus (>/=5 days), Ranson's scores (>/=5), hematocrit (>/=45%) and CT Balthazar scores (>/=7), but not with pathogenesis, serum calium or total parenteral nutrition. Comprehensive prevention of pancreatic infection and individualized therapy may reduce the incidence of infection.
Department of General Surgery, First Clinical Hospital, Harbin Medical University, Harbin 150001, China. sunbei70@163.net
Bei
B
Sun
Ha-Li
HL
Li
Yue
Y
Gao
Jun
J
Xu
Hong-Chi
HC
Jiang
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000453:epidemiology; D001424:Bacterial Infections / Q000453:epidemiology; D005260:Female; D006400:Hematocrit; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D012307:Risk Factors; D012720:Severity of Illness Index