Morbimortality indicators in severe acute pancreatitis.
OBJECTIVE
The aim of this study was to determine the factors related to the development of systemic complications, mortality and pancreatic necrosis in patients with severe acute pancreatitis.


METHODS
Thirty-nine patients (22.3%) out of 175 patients with acute pancreatitis who were admitted to our center, had an APACHE II score greater than 8; they were classified as having severe acute pancreatitis and were evaluated in the study.


METHODS
Sepsis-related Organ Failure Assessment (SOFA) and Marshall scores were obtained. The variables analyzed were age, sex, etiology, hematocrit, leukocyte count, CRP level, CT findings and length of hospital stay. These variables were related to the development of systemic complications, mortality and necrotizing pancreatitis.


RESULTS
The mean APACHE II value of the patients included was 11.6+/-3.1, the mean SOFA score was 3.2+/-2.0 and the Marshall score was 1.5+/-1.9. Eleven patients developed necrotizing pancreatitis. The mortality rate among severe acute pancreatitis patients was 3 out of 39 (7.7%). Variables found to be related to systemic complications were the APACHE II score as well as SOFA and Marshall scores greater than 3. The variables related to mortality were SOFA score greater than 3 and leukocytosis greater than 19,000 mm(-3). CRP greater than 19.5 mg/dL and length of hospital stay were related to necrotizing pancreatitis.


CONCLUSIONS
The scoring systems, especially the SOFA score, were related to the development of systemic complications and mortality. CRP showed a relationship to necrotizing pancreatitis. There was no relationship between the evaluated scoring systems and necrotizing pancreatitis in patients with severe acute pancreatitis.
De Campos
Tercio
T
Emergency Unit of the Medical Sciences Faculty of the Santa Casa of São Paulo, São Paulo, SP, Brazil. tercio@uol.com.br
Cerqueira
Cinara
C
Kuryura
Laíse
L
Parreira
José Gustavo
JG
Soldá
Silvia
S
Perlingeiro
Jacqueline A G
JA
Assef
José Cesar
JC
Rasslan
Samir
S
D018806:APACHE; D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D018450:Disease Progression; D005260:Female; D006801:Humans; D007902:Length of Stay; D007964:Leukocytosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D011237:Predictive Value of Tests; D018805:Sepsis / Q000209:etiology; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D002097:C-Reactive Protein