title: The study on causes of death in fulminant pancreatitis at early stage and late stage.
abstract: OBJECTIVE
  To investigate clinical characteristics of fulminant pancreatitis (FP) died at early and late stage, analyze the difference in death causes of FP at these two stage.
  
  
  METHODS
  Ninety-two (92) patients with FP were admitted in our center from January 2000 to June 2010, and 55 patients of them died of FP. These dead FP patients were divided into two groups according to the death time: within 7 d (early death group) or after 7 d (late death group). The 24 h Acute Physiology and Chronic Heath Evaluation II (APACHE II) score, the occurrence of complications were compared between these two groups.
  
  
  RESULTS
  The mortality of FP was 59.8% (55/92), in which 20.6% (19 cases) died within 3 d and 29.3% (27 cases) died after 14 d. Compared with the late death group, the early death group showed higher 24 h APACHE II score and serum triglyceride level (P < 0.05), and also had higher occurring time of renal failure, shock, hepatic failure, encephalopathy, gastrointestinal hemorrhage and infection (P < 0.05). However, the incidences of encephalopathy, gastrointestinal hemorrhage and pancreatic necrosis infection in the late death group were higher than those in the early group (P < 0.05). In addition, the major pathogenesis of infection was Gram-negative bacterium.
  
  
  CONCLUSIONS
  The most important and common cause of death for the patients with FP is multiple organ dysfunction syndrome, which usually was the consequence of systemic inflammation response syndrome in the early stage, and the severe infection in the later stage, respectively.
authors: Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
authors: Xiao-Nan
authors: XN
authors: Yang
authors: Jia
authors: J
authors: Guo
authors: Zi-Qi
authors: ZQ
authors: Lin
authors: Lei
authors: L
authors: Huang
authors: Tao
authors: T
authors: Jin
authors: Wei
authors: W
authors: Wu
authors: Li
authors: L
authors: Wen
authors: Zhao-Da
authors: ZD
authors: Zhang
authors: Qing
authors: Q
authors: Xia
authors: Wei-Ming
authors: WM
authors: Hu
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality*; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000401:mortality*; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology; D013997:Time Factors