title: Predictors for mortality following acute pancreatitis in children.
abstract: BACKGROUND
  Although there are several studies focusing on pancreatitis etiology and clinical outcome, no previous report has examined the risk factors for death in children.
  
  
  METHODS
  We reviewed the medical records of all children (ages 0-18 years) admitted to West China Hospital with acute pancreatitis between 2002 and 2012. Independent predictors for death following acute pancreatitis in children were identified using a multivariate logistic regression analysis.
  
  
  RESULTS
  Biliary diseases (23%), medications (20%), idiopathic (19%), and trauma (11%) were the most common etiologies for acute pancreatitis in children. The death rate was 5% and the mean duration of hospital stay was 13 days. Organ failure during admission occurred in 24 of 371 patients and most of them started in 3 days of onset (19/24). Multivariate analysis with logistic regression confirmed that occurrence of SIRS in the first week of onset (OR = 2.12, 95% CI 1.14-6.32, P < 0.001), occurrence of organ failure within 3 days of onset (OR = 8.0, 95% CI 2.2-12.3, P < 0.001), occurrence of MOF in the first week of onset (OR = 9.4, 95% CI 2.3-14.6, P < 0.001), infected necrosis (OR = 1.28, 95% CI 1.08-1.52, P = 0.02), and idiopathic cause (OR = 17.3, 95% CI 2.0-60.5, P < 0.001) were independent risk factors for death in cases with pancreatitis.
  
  
  CONCLUSIONS
  Mortality rate and complication rate of acute pancreatitis in children remains low. Patients with SIRS, early organ failure, MOF, infected necrosis, or idiopathic cause should be well evaluated because they have higher risk of death.
authors.affiliation: Hepato-Bilio-Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Guo
authors.forename: Mao
authors.initials: M
authors.lastname: Li
authors.forename: Yang
authors.initials: Y
authors.lastname: Chen
authors.forename: Hankui
authors.initials: H
authors.lastname: Hu
authors.forename: Weiming
authors.initials: W
authors.lastname: Hu
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009102:Multiple Organ Failure / Q000453:epidemiology; D016017:Odds Ratio; D010195:Pancreatitis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology