Severe acute pancreatitis: overall and early versus late mortality in intensive care units.
OBJECTIVE
To determine overall mortality and timing of death in patients with severe acute pancreatitis and factors affecting mortality.


METHODS
This was a retrospective, observational study of 110 patients admitted to a general intensive care unit (ICU) from January 2003 to January 2006.


RESULTS
The overall mortality rate was 53.6% (59/110); 25.4% (n = 15) of deaths were early (<or=14 days after ICU admission). There were no significant differences in age, sex, or surgical/medical treatment between survivors and nonsurvivors. Median Acute Physiology and Chronic Health Evaluation (APACHE) II score was higher among nonsurvivors than survivors (score = 26 vs 19, respectively; P < 0.001), and the duration of hospitalization before ICU admission was significantly longer (4 vs 1 day; P < 0.001). Among the 59 patients who died, those in the early-mortality group were admitted to the ICU significantly earlier than those in the late-mortality group (3 vs 6.5 days; P < 0.05).


CONCLUSIONS
Overall mortality and median APACHE II score were high. Death predominantly occurred late and was unaffected by patient age, length of stay in the ICU, or surgical/medical treatment. An APACHE II cutoff of 24.5 and pre-ICU admission time of 2.5 days were sensitive predictors of fatal outcome.
Bumbasirevic
Vesna
V
Clinical Center of Serbia, Belgrade, Serbia.
Radenkovic
Dejan
D
Jankovic
Zorica
Z
Karamarkovic
Aleksandar
A
Jovanovic
Bojan
B
Milic
Natasa
N
Palibrk
Ivan
I
Ivancevic
Nenad
N
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000401:mortality* / Q000601:surgery; D012189:Retrospective Studies