title: Late infection of pancreatic necrosis: A separate entity in necrotizing pancreatitis with low mortality.
abstract: BACKGROUND
  Several studies have examined on the timing of the onset of infected necrosis and organ failure. The duration of these two complications and the effects of different durations of these two complications have not been mentioned. Our aim was to investigate the durations of these two complications and the corresponding effects of the different durations.
  
  
  METHODS
  A post-hoc analysis was performed on a prospective database containing 578 patients with necrotizing pancreatitis. The patients who received intervention were divided into subgroups based on different durations of the two complications, and the outcomes were compared.
  
  
  RESULTS
  The mortality rate in patients with late infection (occurred after 30 days) was lower than in the early (infection occurred within 30 days) group (3% vs. 22%, P < 0.05). The mortality rate in patients with long duration (>7 days) of infection before intervention was similar with those patients with short duration (≤7 days) of infection (6/27 vs. 11/74; P = 0.38). The mortality rate in patients with long duration (>7 days) of organ failure before intervention was higher than in patients with short duration (≤7 days) of organ failure (31/99 vs. 18/184; P < 0.001).
  
  
  CONCLUSIONS
  Patients with late developed infection of pancreatic necrosis showed significantly better prognosis than patients with early infection. The duration of organ failure before intervention was correlated with mortality of necrotizing pancreatitis.
authors.affiliation: Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan Province, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan Province, China.
authors.forename: Ang
authors.initials: A
authors.lastname: Li
authors.affiliation: Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan Province, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xia
authors.affiliation: Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan Province, China. Electronic address: huweiming64@gmail.com.
authors.forename: Weiming
authors.initials: W
authors.lastname: Hu
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D009336:Necrosis; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000150:complications; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
keywords: Acute pancreatitis; Duration; Infection; Intervention; Mortality; Organ failure