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Letter
Duration of organ failure impacts mortality in acute pancreatitis
  1. Na Shi1,
  2. Tingting Liu1,2,
  3. Daniel de la Iglesia-Garcia3,
  4. Lihui Deng1,
  5. Tao Jin1,
  6. Lan Lan4,
  7. Ping Zhu1,
  8. Weiming Hu5,
  9. Zongguang Zhou6,
  10. Vikesh Singh7,
  11. J Enrique Dominguez-Munoz3,
  12. John Windsor8,
  13. Wei Huang1,2,
  14. Qing Xia1,
  15. Robert Sutton2
  1. 1 Department and Laboratory of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu, China
  2. 2 Liverpool Pancreatitis Study Group, Royal Liverpool University Hospital and Institute of Translational Medicine, University of Liverpool, Liverpool, UK
  3. 3 Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Spain
  4. 4 West China Biomedical Big Data Centre, West China Hospital, Sichuan University, Chengdu, China
  5. 5 Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, China
  6. 6 Institute of Digestive Surgery, West China Hospital, Sichuan University, Chengdu, China
  7. 7 Pancreatitis Centre, Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, USA
  8. 8 Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
  1. Correspondence to Dr Wei Huang, Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, 5B Floor 2nd Building, Tianfu Life Science Park of Hi-Tech Industrial Development Zone, No 88 Keyuan South Road, Chengdu 610041, China; dr_wei_huang{at}scu.edu.cn and Dr Qing Xia, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, No 37 Wannan Guoxue Alley, Chengdu 610041, China; xiaqing{at}medmail.com.cn

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We read with great interest the recent Gut publication by Schepers et al 1 reporting no association between the time of onset or duration of persistent organ failure (POF, >48 hours, distinguished from transient organ failure <48 hours) and mortality in a subset of patients (240/639) with acute pancreatitis (AP). Previously it has been proposed that there are two peaks of POF and mortality in patients with AP, namely the early phase (first week) accompanied by persistent systemic inflammatory response syndrome and late phase (>second week) caused by infected pancreatic necrosis (IPN).2 Patients with early fulminant POF have been considered to have a higher mortality than those developing POF later,3–6 and those with POF in combination with IPN to have a higher mortality than those with POF alone.7 The findings from Schepers et al 1 have challenged these views but require confirmation. We have determined whether their findings are applicable to our AP patient populations.

We analysed 2145 and 939 patients with AP from retrospective (single centre) and prospective cohorts (multicentre), respectively, who were admitted ≤48 hours of symptoms onset (online supplementary table 1). There were 469 (21.9%) and 132 (14.1%) patients …

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