Onset time of complications in patients with severe acute pancreatitis receiving nonoperative therapy.
OBJECTIVE
To retrospectively analyze 85 hospitalized nonoperative patients with severe acute pancreatitis (SAP) and to find out the stages of the disease.


METHODS
We statistically calculated the time of onset of complications in these patients from 1987 to 1999.


RESULTS
The 95% confidence interval of total average for the complications of acute respiratory distress syndrome (ARDS), shock and kidney failure was between 2 to 4 days, and for encephalopathy, hemorrhage of the digestive tract, bacterial infection, fungous infection and abscess between 3 to 6 days, 3 to 5 days, 13 to 16 days, 13 to 16 days, and 14 to 23 days respectively. The 95% confidence interval of total average in 18 deaths (21%) was between 5 to 6 days. ARDS, kidney failure, and shock occurred within 4 days, encephalopathy within 6 days (average 4.8+/-0.9 days), abscesses after 14 days, systemic bacterial infection and fungous infection within half a month (average 14.6+/-1.1 days, 14.8+/-0.9 days respectively), and death within 6 days.


CONCLUSIONS
According to the time of the occurrence of complications, we divide the courses of the disease into three stages: early phase (first 4 days) with ARDS, kidney failure, shock, encephalopathy and hemorrhage of the digestive tract; middle phase (5-15 days) with bacterial infection and fungous infection; late phase (15 days after the onset) with abscess.
Gong
Zeng-Yi
ZY
Department of Surgery, Putuo District People's Hospital, Shanghai 200060, China.
Tang
Yao-Qing
YQ
D000208:Acute Disease; D001424:Bacterial Infections / Q000401:mortality; D001928:Brain Diseases, Metabolic / Q000209:etiology / Q000401:mortality; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality; D006801:Humans; D008297:Male; D009181:Mycoses / Q000401:mortality; D010195:Pancreatitis / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D051437:Renal Insufficiency / Q000209:etiology / Q000401:mortality; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012720:Severity of Illness Index