title: [Acute pancreatitis in intensive care medicine : Which risk score is useful?]
abstract: BACKGROUND
  Acute pancreatitis is a disease with an increasing incidence in the Western countries associated with a high mortality depending on severity of disease. Etiology is often biliary or due to alcoholism. Incidence of etiology varies between regions depending on risk-factor prevalence. Several risk scores are available to estimate mortality. The aim of the study is to identify the risk factors most relevant for patients being treated for severe acute pancreatitis in an ICU of a tertiary medical center.
  
  
  METHODS
  The retrospective cohort study included 91 patients (61.2% men, mean age 52 years) with severe acute pancreatitis who were treated between 2002 and 2013 at the medical ICU of a tertiary medical center. Risk factors were identified using COX regression analysis and associations were assessed with the χ2test.
  
  
  RESULTS
  Pulmonary failure necessitating ventilator support, renal failure requiring renal replacement therapy, need for vasopressor therapy, positive blood cultures, and bleeding complications were identified as risk factors for high mortality in severe acute pancreatitis. Low calcium and high lactate levels are independent risk factors for mortality.
  
  
  CONCLUSIONS
  Critically ill patients with severe pancreatitis have high mortality rates that can be estimated using risk scores. Weighting of risk factors may differ depending on region and severity of disease. For patients included in our study, the Ranson Criteria and the APACHE II Score may be most applicable.
authors.affiliation: Department für Kardiologie und Angiologie, Abteilung für Elektrophysiologie, Universitätsklinik Münster, Albert-Schweitzer Campus A1, 48149, Münster, Deutschland. alicia.fischer@ukmuenster.de.
authors.forename: A J
authors.initials: AJ
authors.lastname: Fischer
authors.affiliation: Department für Kardiologie und Angiologie, Klinik für Kardiologie, Universitätsklinik Münster, Münster, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Andreottola
authors.affiliation: Medizinische Klinik B, Universitätsklinik Münster, Münster, Deutschland.|Department für Palliativmedizin, Universitätsklinik Münster, Münster, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Lenz
authors.affiliation: Department für Kardiologie und Angiologie, Klinik für Kardiologie, Universitätsklinik Münster, Münster, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Lebiedz
mesh_terms: D002118:Calcium / Q000097:blood; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000145:classification / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D019344:Lactic Acid; D002118:Calcium
keywords: Acute pancreatitis; Mortality; Risk factors; Score