title: Analysis of factors influencing survival in patients with severe acute pancreatitis.
abstract: OBJECTIVE
  Acute pancreatitis (AP) ranges from a mild and self-limiting disease to a fulminant illness with significant morbidity and mortality. Severe acute pancreatitis (SAP) is defined as persistent organ failure lasting for 48 h. We aimed to determine the factors that predict survival and mortality in patients with SAP.
  
  
  METHODS
  We reviewed a consecutive series of patients who were admitted with acute pancreatitis between January 2003 and January 2013. A total of 1213 cases involving 660 patients were evaluated, and 68 cases with SAP were selected for the study. Patients were graded based on the Computer Tomography Severity Index (CTSI), the bedside index for severity (BISAP), and Ranson's criteria.
  
  
  RESULTS
  The frequency of SAP was 5.6% (68/1213 cases). Among these patients, 17 died due to pancreatitis-induced causes. We compared several factors between the survivor (n = 51) and non-survivor (n = 17) groups. On multivariate analysis, there were significant differences in the incidence of diabetes mellitus (p = .04), Ranson score (p = .03), bacteremia (p = .05) and body mass index (BMI) (p = .02) between the survivor and non-survivor groups.
  
  
  CONCLUSIONS
  Bacteremia, high Ranson score, DM, and lower BMI were closely associated with mortality in patients with SAP. When patients with SAP show evidence of bacteremia or diabetes, aggressive treatment is necessary. For the prediction of disease mortality, the Ranson score might be a useful tool in SAP.
authors.affiliation: a Department of Internal Medicine , St. Vincent's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea.
authors.forename: Yeon Ji
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: a Department of Internal Medicine , St. Vincent's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea.
authors.forename: Dae Bum
authors.initials: DB
authors.lastname: Kim
authors.affiliation: a Department of Internal Medicine , St. Vincent's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea.
authors.forename: Woo Chul
authors.initials: WC
authors.lastname: Chung
authors.affiliation: a Department of Internal Medicine , St. Vincent's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea.
authors.forename: Ji Min
authors.initials: JM
authors.lastname: Lee
authors.affiliation: a Department of Internal Medicine , St. Vincent's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea.
authors.forename: Gun Jung
authors.initials: GJ
authors.lastname: Youn
authors.affiliation: a Department of Internal Medicine , St. Vincent's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea.
authors.forename: Yun Duk
authors.initials: YD
authors.lastname: Jung
authors.affiliation: a Department of Internal Medicine , St. Vincent's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea.
authors.forename: Sooa
authors.initials: S
authors.lastname: Choi
authors.affiliation: b Department of Internal Medicine , St. Paul's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea.
authors.forename: Jung Hwan
authors.initials: JH
authors.lastname: Oh
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000150:complications; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000401:mortality*; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
keywords: Acute pancreatitis; Ranson score; bacteremia; diabetes mellitus; mortality