title: Clinical implications and risk factors of acute pancreatitis after cardiac valve surgery.
abstract: OBJECTIVE
  Acute pancreatitis is one of the potentially lethal complications that occurs after cardiac surgery. We tried to identify risk factors for and the prognosis of acute pancreatitis after cardiac valve surgery with cardiopulmonary bypass.
  
  
  METHODS
  We retrospectively analyzed a database of consecutive patients who underwent cardiac valve surgery with cardiopulmonary bypass between January 2005 and April 2010 at our institution. Patients were classified as having acute pancreatitis based on serum lipase concentration and clinical symptoms (lipase ≥ 180 U/L or ≥ 60 U/L with relevant symptoms).
  
  
  RESULTS
  Of the 986 patients who underwent cardiac valve surgery with cardiopulmonary bypass, 58 (5.9%) patients developed post-operative pancreatitis. Post-operative hospital stay was significantly longer (29.7 ± 45.6 days vs. 12.4 ± 10.7 days, p = 0.005) and in-hospital mortality rate was higher (15.5% vs. 2.0%, p<0.001) in patients with post-operative pancreatitis than those without. Hypertension, chronic kidney disease, and peri-operative use of norepinephrine were identified as independent risk factors for developing pancreatitis after cardiac valve surgery.
  
  
  CONCLUSIONS
  We found that acute pancreatitis after cardiac valve surgery requires longer hospitalization and increases the in-hospital mortality rate. Clinicians should be aware that patients could develop pancreatitis after cardiac valve surgery, especially in patients with hypertension and chronic kidney disease treated with norepinephrine.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
authors.forename: Joo Won
authors.initials: JW
authors.lastname: Chung
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Ryu
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Jo
authors.forename: Jeong Youp
authors.initials: JY
authors.lastname: Park
authors.forename: Sak
authors.initials: S
authors.lastname: Lee
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Si Young
authors.initials: SY
authors.lastname: Song
authors.forename: Jae Bock
authors.initials: JB
authors.lastname: Chung
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009638:Norepinephrine / Q000627:therapeutic use; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology*; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D008049:Lipase; D009638:Norepinephrine