title: Severe acute pancreatitis: overall and early versus late mortality in intensive care units.
abstract: 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.
authors.affiliation: Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Bumbasirevic
authors.forename: Dejan
authors.initials: D
authors.lastname: Radenkovic
authors.forename: Zorica
authors.initials: Z
authors.lastname: Jankovic
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Karamarkovic
authors.forename: Bojan
authors.initials: B
authors.lastname: Jovanovic
authors.forename: Natasa
authors.initials: N
authors.lastname: Milic
authors.forename: Ivan
authors.initials: I
authors.lastname: Palibrk
authors.forename: Nenad
authors.initials: N
authors.lastname: Ivancevic
mesh_terms: 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