[Detection of early organ dysfunction for the selection of treatment strategy on severe acute pancreatitis.].
OBJECTIVE
To investigate the severity related influencing factor and treatment strategy of severe acute pancreatitis with early organ dysfunction.


METHODS
From July 2007 to December 2008, 167 patients with severe acute pancreatitis were treated in the Surgical Department of Ruijin Hospital. The relationships between the happening of early organ dysfunction and outcome of the patients were observed, with operative or nonoperative treatment strategy.


RESULTS
Among 167 patients, 68 patients have early organ dysfunction, in which 39 with single organ dysfunction and 29 with multiple organ dysfunction. The early organ dysfunction were involved in 47.1% in cardiovascular system, 35.3% in lung and 29.4% in kidney. Aging (P < 0.05) and higher APACHE II score (P < 0.05) predicted a poor prognosis, which were benefit from early operation.


CONCLUSIONS
The mortality of the patients with SAP is related to age, and the degree of organ dysfunction as well. In the first phase of the disease, the selection of operation depends on the trends and the degree of early organ dysfunction before infected necrosis happens, with the aid of SOFA score as a scale.
Lu
Yi-Fan
YF
Department of Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China.
Lei
Ruo-Qing
RQ
Xu
Zhi-Wei
ZW
Deng
Yang
Y
Chen
Sheng
S
Li
Hong-Chang
HC
Chai
Chun-Yu
CY
Han
Tian-Quan
TQ
Tang
Yao-Qing
YQ
Zhang
Sheng-Dao
SD
D000208:Acute Disease; D000375:Aging; D006801:Humans; D009102:Multiple Organ Failure; D010195:Pancreatitis / Q000175:diagnosis; D011379:Prognosis