[Analysis of fatal risk factors for severe acute pancreatitis: a report of 141 cases].

OBJECTIVE: To investigate the risk factors affecting the mortality of severe acute pancreatitis (SAP).

METHODS: The clinical data of 141 patients with SAP treated from January 2001 to October 2005 were analyzed retrospectively. All the patients were divided into 2 groups, the death group and the survival group. Fifteen potential factors influencing the prognosis of SAP were analyzed with Logistic regression analysis.

RESULTS: Thirty-four cases (24.1%) among the 141 patients died. There were significant differences between the two groups in age, body mass index, length of stay, APACHE II score, multiple organ dysfunction syndrome (MODS) and abdominal compartment syndrome (ACS) (P < 0.05). Multiple-factor Logistic regression analysis indicated that the MODS (OR = 67. 358, P < 0.01), APACHE II score (OR =9.716, P < 0.01) and ACS (OR = 5.775, P < 0.05) were the independent risk factors affecting the prognosis of SAP during its early stage, whereas pancreatic infection (OR = 9.652, P < 0.01), MODS (OR = 5.212, P < 0.05) and celiac hemorrhage (OR = 4.707, P < 0.05) were the independent risk factors during the advanced stage of SAP.

CONCLUSIONS: MODS,especially respiratory dysfunction and renal dysfunction,is the main cause of early mortality for SAP, whereas infection, multiple organ dysfunction and celiac hemorrhage may impact the later mortality. Therefore early prevention and correct management on the risk factors play critical roles in reducing the mortality of SAP.