The pattern of organ dysfunction in acute pancreatitis / 中华胰腺病杂志

ABSTRACT

Objective To investigate the pattern of organ dysfunction in acute pancreatitis.Methods Seven hundred and eighty-three SAP patients who were treated in Department of Surgery,Ruijin Hospital from January 2001 to December 2008 were retrospectively analyzed.According to 2012 acute pancreatitis classification,these SAP patients were further divided into MSAP and SAP.Diagnosis of organ dysfunction was based on SOFA scores.Results Among the 783 patients,there were 573 MSAP patients and 210 SAP patients.The main etiology was of biliary origin (47.9％).Six hundred and ninety-eight patients survived,and 85 patients died with the mortality rate of 10.9％.Among the 783 patients,organ dysfunction occurred in 273(34.9％) patients,and the number of patients with 1,2,3,4 or more organs dysfunction was 109,81,60 and 23,and the mortality was 1.8％ (2 patients),37.0％ (30 patients),50.0％ (30 patients),100％.Among the 109 patients with single organ dysfunction,there were 48 MSAP and 61 SAP patients,and 98.2％ was cured,only 2 patients died.Among the 164 patients with multiple organ dysfunction,there were 15 MSAP and 149 SAP patients,and 50.6％ died.Respiratory,cardiovascular,nervous,renal,hematologic and liver dysfunction occurred in 206 (26.3％),103 (13.2％),92 (11.7％),80 (10.2％),41 (5.2％),27 (3.4％); and the mortality rates were 38.8％ (126/206),49.5％ (51/103),37.0％ (34/92),63.8％ (51/80),53.7％ (22/4),44.4％ (12/27).Respiratory dysfunction had the highest incidence,and renal failure was associated with the highest mortality.Conclusions In the course of acute pancreatitis,single organ dysfunction has the highest incidence but the mortality is low.Four or more organs dysfunction has the lowest incidence,but the mortality is 100％.Respiratory and cardiovascular dysfunction has the highest incidence,and renal,hematologic dysfunction is associated with poorest prognosis.