Abstract:

Objective To investigate the risk factors of death in patients with severe acute pancreatitis (SAP). Methods The clinical data of 906 patients with SAP were retrospectively analyzed. Patients were divided into death group and survival group based on the outcomes. The age, gender, acute physiology and chronic health evaluation (APACHE) Ⅱ score, Ranson score, CT severity index (CTSI), disease cause, single or multiple organ dysfunction/failure, operation and complications were compared between two groups. Results There were 149 patients in death group and 757 patients in survival group. In death group, 45% patients died within 14 d after disease onset. The mortality of idiopathic SAP (28.0%) was higher than those of biliary SAP (16.6%) and hyperlipidemic SAP (5.5%)(P<0.05). The incidence of multiple organ dysfunction/failure in death group (76.5%) was significantly higher than that in survival group (12.7%)(P<0.05). The highest incidence of complications in death group was severe sepsis (53.0%), which was significantly higher than that in survival group (23.2%)（P<0.05）. The incidence of debridement in death group was higher than that in survival group (P>0.05). Conclusion The death of patients with SAP was associated with age, disease cause, multiple organ dysfunction/failure, severe infection and local complications. In order to decrease mortality, it is important to perform individual diagnosis and treatment, and prevent the complications and organ dysfunction promptly.

Key words: severe acute pancreatitis, mortality, clinical characteristics