Risk factors for pancreatic infection in patients with severe acute pancreatitis: an analysis of 163 cases.
OBJECTIVE
We aimed to identify the risk factors for predicting pancreatic infection in patients with severe acute pancreatitis (SAP).


METHODS
In all, 163 patients with SAP were included and divided into two groups based on the presence or absence of pancreatic infection. Their demographic and clinical characteristics, laboratory examination results, complications and treatment modalities were collected from their medical records. Variables were initially screened by univariate analysis and those with statistical significance were then filtered by multivariate analysis to determine the independent risk factors for pancreatic infection in SAP.


RESULTS
Patients having SAP with pancreatic infection had a lower partial pressure of arterial carbon dioxide (PaCO2 ), peripheral white blood cell count and alkaline phosphatase levels, together with a higher computed tomography severity index (CTSI) than those without pancreatic infection, while their lactate dehydrogenase (LDH) levels and blood urea nitrogen were much higher. Pancreatic infection was also more common in patients receiving late fluid resuscitation than in those receiving early fluid resuscitation. Multivariate analyses revealed that increased LDH level, high CTSI, delayed fluid resuscitation and hypoxemia were independent risk factors for pancreatic infection in SAP. The sensitivity, specificity, positive and negative predictive values for a model combining the parameters in predicting pancreatic infection were 84%, 97%, 88% and 96%, respectively, with a cut-off value of 0.393, and the area under the receiver operating characteristic curve was 0.923.


CONCLUSIONS
Increased LDH, high CTSI, delayed fluid resuscitation and hypoxemia are independent risk factors for predicting pancreatic infection in patients with SAP.
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Yan Bo
YB
Zeng
Xian Bao
XB
Zhan
Xiao Rong
XR
Guo
Hua Gao
HG
Zhang
Yan
Y
Chen
Quan Cai
QC
Cai
Zhao Shen
ZS
Li
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000150:complications; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010100:Oxygen / Q000097:blood; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications*; D010313:Partial Pressure; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002245:Carbon Dioxide; D007770:L-Lactate Dehydrogenase; D010100:Oxygen
acute necrotizing pancreatitis; diagnosis; hypoxemia; pancreatic infection; pancreatitis; risk factor