title: Early hemodynamic variables and outcome in severe acute pancreatitis: a retrospective single-center cohort study.
abstract: OBJECTIVE
  The aim of this study was to assess the association of hemodynamic factors with 90-day mortality in critically ill patients with severe acute pancreatitis (SAP).
  
  
  METHODS
  One hundred fifty-nine consecutive patients with SAP admitted to the intensive care units between January 2005 and December 2008 were included in study. We assessed the association of hemodynamic variables during the first 24 hours in the intensive care unit with 90-day mortality using multivariate analysis for all patients with SAP and for a subgroup with circulatory shock.
  
  
  RESULTS
  Advanced age (odds ratio [OR], 1.09; 95% confidence interval, 1.04-1.15 per year), higher serum creatinine (OR, 1.01; 95% confidence interval, 1.00-1.02 per unit), and lower mean arterial pressure (OR, 0.92; 95% confidence interval, 0.86-0.99 per mm Hg) were independently associated with 90-day mortality. In the subgroup of SAP with shock, higher Acute Physiology and Chronic Health Evaluation II score (OR, 1.15; 95% confidence interval, 1.00-1.32 per point), higher central venous pressure (OR, 1.25; 95% confidence interval, 1.03-1.52 per mm Hg), and lower cardiac index (OR, 0.33; 95% confidence interval, 0.11-0.98 per L/min per m²) were independent risk factors for 90-day mortality.
  
  
  CONCLUSIONS
  Advanced age, higher serum creatinine, and lower mean arterial pressure are associated with 90-day mortality in patients with SAP. In the subgroup of patients with SAP and shock, higher Acute Physiology and Chronic Health Evaluation II score, higher central venous pressure, and lower cardiac index predicted 90-day mortality.
authors.affiliation: Intensive Care Units, Division of Anaesthesia and Intensive Care Medicine, Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland. erika.wilkman@hus.fi
authors.forename: Erika
authors.initials: E
authors.lastname: Wilkman
authors.forename: Kirsi-Maija
authors.initials: KM
authors.lastname: Kaukonen
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
authors.forename: Anne
authors.initials: A
authors.lastname: Kuitunen
authors.forename: Marjut
authors.initials: M
authors.lastname: Varpula
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D062186:Arterial Pressure; D015415:Biomarkers / Q000097:blood; D002496:Central Venous Pressure; D003404:Creatinine / Q000097:blood; D016638:Critical Illness; D005260:Female; D005387:Finland; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010195:Pancreatitis / Q000097:blood / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012769:Shock / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine