Analysis of risk factors of infected pancreatic necrosis in the later stage of acute pancreatitis:A report of 153 patients

doi:10.7504/CJPS.ISSN1005-2208.2015.05.19

Abstract：Objective To investigate influence factors of the development of infected pancreatic necrosis (IPN) in the later course of pancreatitis. Methods The clinical data of 153 patients with acute pancreatitis admitted from January 2012 to July 2014 in Department of General Surgery,Nanjing General Hospital of Nanjing Military Command of PLA were analyzed retrospectively. The patients were divided into two groups according to the presence of infection pancreatic necrosis (IPN):non-infection (n=123) and infection (n=30) group. The clinical characteristics and laboratory parameters were measured on admission and compared between the two groups. Logistic regression model was constructed to predict the possible risk factors for IPN. Results Univariate logistic regression analysis suggested that there was significant difference in APACHE Ⅱ score,platelet,C-reactive protein,absolute lymphocyte count,lymphocyte proportion, neutrophil-lymphocyte ratio (NLR),albumin as well as HLA-DR between two groups (P<0.05). Multivariate logistic regression analysis indicated that APACHE Ⅱ score and absolute lymphocyte count were independent predictors for IPN. The critical value of lymphocyte proportion for predictry IPN was 0.7 × 109/L, sensitinty was 83.79%, and sptificity was 66.7%. Conclusion Monitoring the absolute lymphocyte count in the early phase of acute pancreatitis may be an effective way to predict the possibility of IPN in the later course of pancreatitis.