Clinical and prognostic features of acute pancreatitis complicated with specific single organ failure

Wang Yu-bin; Zhang Chang-qing; Zhang Kui-ling; Zhou A-pei

doi:10.3969/j.issn.1002-1949.2018.04.012

Abstract：Objective To investigate the clinical and prognostic features of acute pancreatitis (AP) complicated with specific single organ failure.Methods The clinical and prognostic data of a total of 135 patients with AP and developed organ failure in our hospital in the past 5 years during July 2012 to June 2017,were retrospectively analyzed.The specific single organ failure and multiple organ failure (2 or more) were defined and divided according to the number of failed organs.The proportion of specific single organ failure in all the AP patients with organ failure,and in MSAP and SAP were measured respectively.The frequency of different specific single organ failure,the demographic and clinical parameters such as gender,age,etiology,APACHE Ⅱ score,rate of ICU admission,length of stay in ICU and hospital,and mortality were compared among the patients with different specific single organ failure.Results Among the 135 patients of AP with organ failure,80 cases belonged to MSAP,and 55 cases belonged to SAP.The specific single organ failure occurred in 99 patients,and multiple organ failure in 36 patients.The proportion of specific single organ failure in MSAP,SAP and MSAP +SAP was 80％ (64/80),63.6％ (35/55) and 73.3％ (99/135) retrospectively.MSAP showed a higher proportion of specific single organ failure (x2 =4.463,P =0.035).The frequency of different specific single organ failure was respectively 68.7％ (68/99) for pulmonary failure,28.3％ (28/99) for renal failure,and 3％ (3/99) for circulatory failure.The frequency of different specific single organ failure in MSAP and SAP were similar (x2 =0.191,P =0.909).Compared with the solitary renal failure,the APACHEⅡ score (MSAP:8.6±3.5 vs.6.5±2.9,t =2.288,P=0.026;SAP:15.9 ±5.7 vs.11.2±4.8,t =2.203,P=0.035),ICU admission (MSAP:55.8％ vs.26.3％,x2 =4.606,P=0.032;SAP:100％ vs.55.6％,x2 =12.593,P＜ 0.001),and ICU stay (MSAP:5.2±3.1 vs.1.8±2.0,t=2.334,P=0.027;SAP:12.2±6.3vs.4.1 ±2.4,t=2.801,P=0.009) of AP patients with solitary pulmonary failure were significantly higher.However,the gender,age,etiology,hospital stay,and mortality were not different between solitary pulmonary failure and solitary renal failure.Conclusion The rate of specific single organ failure in MSAP and SAP is higher,especially in MSAP.The most common specific single organ failure is solitary respiratory failure and solitary renal failure.Compared with single renal failure,solitary respiratory failure is more critical,and intensive care should be strengthened.