Clinical Analysis Of Mortality And Risk Factor Of Severe Acute Pancreatitis

Objective To investigate the clinical data of severe acute pancreatitis(SAP) and explore the prognostic dangerous factors influencing mortality.Methods Clinical data of 115 cases with SAP admitted to the first affiliated hospital of Guangxi Medical University from January 2003 to December 2007 were reviewed retrospectively. The patients were divided into two groups based on their prognosis,survival group(117 cases)and fatality group(38 cases).Clinical and laboratory data ,incidence of organ dysfunction during hospitalization between two groups were compared,then the prognostic dangerous factors influencing mortality of SAP were analysed.Results There were significant differences in hematocrit , persistence time of serum amylase, serum creatinine, serum calcium, serum glucose, pH value,oxygen index, between fatality group and survival group[ (0.34±0.11)vs (0.39±0.10) , (3.00±4.00) vs (5.00±8.75) days, (366.42±250.83) vs(115.13±86.32)umol/L,(1.71±0.46)vs(1.90±0.26)mmol/l,( 13.99±6.70)vs(10. 61±4.70)mmol/l,(7.29±0.14)vs(7.40±0.06),(219.16±95.60)vs(324.88±115.77) mmHg, P<0.05) ]. APACHE II scores of the fatality group were higher than the survival group(23.66±8.28vsl2.49±5.04, P<0.05) .The incidence rate of respiratory, renal, cardiovascular, gastrointestinal , coagulation dysfunction and pancreatic encephalopathy of the fatality group was higher than the survial group (100%vs803%,86.8%vs22.2%,92.1%vs21.4%,81.6% vs21.4%, 44.7%vs2.6%,31.6%vs5.1%, P<0.05) .The Multivariate Logistic regression analysis showed that the dangerous factors relating to death were respiratory, renal, cardiovascular dysfunction (OR 12.43,28.49,25.59,all P<0.01).Conclusions It is useful to evaluate the prognosis in hematocrit , persistence time of serum amylase, serum creatinine, serum calcium, serum glucose, pH value,oxygen index. APACHE II and Balthazar CT scoring system should be use to evaluate the diagnosis and prognosis of SAP. The prognostic dangerous factors influencing mortality are respiratory, renal, cardiovascular dysfunction.