title: Audit of patients with severe acute pancreatitis admitted to an intensive care unit.
abstract: BACKGROUND
  Severe acute pancreatitis (SAP) is a disease with high morbidity and mortality. We undertook a study of patients with SAP admitted to the intensive care unit (ICU) of a tertiary referral hospital.
  
  
  METHODS
  Between 2002 and 2007, 50 patients with SAP were admitted in our intensive care unit (ICU). Data were collected from their medical records and their clinical profile, course and outcome were retrospectively analyzed. Patients were categorized into survivor and nonsurvivor groups, and were further classified based on interventions such as percutaneous drainage and surgical necrosectomy.
  
  
  RESULTS
  SAP contributed 5 % of total ICU admissions during the study period. Median age of survivors (n = 20) was 34 against 44 years in nonsurvivors (n = 30). Median Acute Physiology and Chronic Health Evaluation (APACHE) II score in nonsurvivors was 16.5 (8-32) vs. 12.5 (5-20) in survivors (p = 0.002). Patients with APACHE II score ≥12 had mortality >80 % compared to 23 % with score <12 (p < 0.001). Median Sequential Organ Failure Assessment (SOFA) scores on admission and on days 3, 7, 14, and 21 were significantly higher in nonsurvivors compared to survivors (p < 0.05). Mean (SD) intraabdominal pressure was 23 (3.37) mmHg in nonsurvivors vs. 19.05 (2.51) in survivors (p < 0.05). Patients with renal failure had significant mortality (p < 0.001). Length of ICU stay, requirement for vasopressor, total parenteral nutrition, and the amount of blood and blood product transfusions differed significantly between patients with and without intervention.
  
  
  CONCLUSIONS
  APACHE II and SOFA scores and other clinical data correlated with outcome in SAP admitted to ICU.
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India. ratender@sgpgi.ac.in
authors.forename: Ratender Kumar
authors.initials: RK
authors.lastname: Singh
authors.forename: Banani
authors.initials: B
authors.lastname: Poddar
authors.forename: Arvind Kumar
authors.initials: AK
authors.lastname: Baronia
authors.forename: Afzal
authors.initials: A
authors.lastname: Azim
authors.forename: Mohan
authors.initials: M
authors.lastname: Gurjar
authors.forename: Sanjay
authors.initials: S
authors.lastname: Singhal
authors.forename: Shilpi
authors.initials: S
authors.lastname: Srivastava
authors.forename: Saurabh
authors.initials: S
authors.lastname: Saigal
mesh_terms: D000328:Adult; D002423:Cause of Death; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007194:India; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D062606:Tertiary Care Centers