Severe acute pancreatitis: Overall and early versus late mortality in intensive care units

Abstract

OBJECTIVES: To determine overall mortality and timing of death in patients with severe acute pancreatitis and factors affecting mortality. METHODS: This was a retrospective, observational study of 110 patients admitted to a general intensive care unit (ICU) from January 2003 to January 2006. RESULTS: The overall mortality rate was 53.6% (59/110); 25.4% (n = 15) of deaths were early (≤14 days after ICU admission). There were no significant differences in age, sex, or surgical/medical treatment between survivors and nonsurvivors. Median Acute Physiology and Chronic Health Evaluation (APACHE) II score was higher among nonsurvivors than survivors (score = 26 vs 19, respectively; P < 0.001), and the duration of hospitalization before ICU admission was significantly longer (4 vs 1 day; P < 0.001). Among the 59 patients who died, those in the early-mortality group were admitted to the ICU significantly earlier than those in the late-mortality group (3 vs 6.5 days; P < 0.05). CONCLUSIONS: Overall mortality and median APACHE II score were high. Death predominantly occurred late and was unaffected by patient age, length of stay in the ICU, or surgical/medical treatment. An APACHE II cutoff of 24.5 and pre-ICU admission time of 2.5 days were sensitive predictors of fatal outcome. Copyright © 2009 by Lippincott Williams & Wilkins.