Relationship of necrosis to organ failure in severe acute pancreatitis

doi:10.1016/S0016-5085(97)70185-9

Gastroenterology

Volume 113, Issue 3, September 1997, Pages 899-903

https://doi.org/10.1016/S0016-5085(97)70185-9 Get rights and content

Abstract

BACKGROUND & AIMS: Pancreatic necrosis and organ failure are principal determinants of severity in acute pancreatitis. The purpose of this study was to determine the relationship of necrosis to organ failure in severe acute pancreatitis. METHODS: Patients with necrotizing pancreatitis from May 1992 to January 1996 were retrospectively studied. Pancreatic necrosis was identified by characteristic findings on dynamic contrast-enhanced computerized tomography scan and infected necrosis by computerized tomography-guided percutaneous aspiration. Organ dysfunction was defined in accordance with the Atlanta symposium. RESULTS: Organ failure was present in only 26 of 51 patients (51%). There was no difference in the prevalence of organ failure in infected necrosis compared with sterile necrosis (approximately 50% in both groups). Patients with increased amounts of necrosis did not have an increased prevalence of organ failure or infected necrosis compared with those with lesser amounts of necrosis. Patients with organ failure had an increased morbidity and mortality compared with those without organ failure. CONCLUSIONS: Organ failure occurred in only one half of patients with necrotizing pancreatitis. Because organ failure increases the severity of illness, studies of patients with necrotizing pancreatitis must stratify for organ failure to facilitate interpretation of results. (Gastroenterology 1997 Sep;113(3):899-903)

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Citation Excerpt :
Although mortality rate of severe AP has decreased in recent years, it is still about 20–25% [35]. A mortality rate of 50% is expected in the development of complications such as pancreatic necrosis in geriatric population [36,37]. Despite age is generally accepted as a risk factor for multisystem organ failure, there are controversial data about increased mortality from AP in elderly patients [5,10].
Although well understanding the course of diseases in geriatric population is of paramount importance in order to provide the optimal treatment, there is only a few studies with controversial results that have been conducted about the course and outcomes of acute pancreatitis (AP) in elderly. We aimed to compare clinical outcomes of AP disease in geriatric age group and to evaluate the risk factors affecting outcomes.
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