Analysis Of Death-related Risk Factors In 183 Patients With Severe Acute Pancreatitis

ObjectiveTo identify the risk factors related to the mortality of severe acute pancreatitis through the analysis of 183 cases that diagnoses were severe acute pancreatitis.And help us to direct management,judge prognosis and cut down the mortality of SAP.MethodsClinical data of 183 cases of severe acute pancreatitis in Tianjin First Central Hospital from August 2002 to December 2008 were collected and analyzed retrospectively.All the cases the APACHEâ…¡score were higher than eight.There were 101 males and 81 females.Cases were divided into death group and survival group according to their outcome.There were 137cases in death group(87/50,M/F) 46 cases in survival group(29/17,M/F).The characteristics,the results of blood tests and functions of organs were analyzed.ResultsIn comment data the age,APACHEâ…¡score and Ranson score were different between the two groups(P＜0.05).Comparing the chemistry data of the two group, hematocrit(HCT),blood calcium(Ca),serum creatinine(Cr),serum glucose(BG)and bilirubin total(TB) were different(P＜0.05).Comparing the Coagulation function of the two group,KPTT,FIB,D-D were different(P＜0.05).The incidence rates of acute respiratory distress syndrome(ARDS),heart failure,renal failure and MODS of the death group were higher than the survival group(P＜0.05).The incidence rate of abdominal dropsy was also different between them.Multivariate logistic regression showed that independent risk factors of SAP included age,abdominal dropsy,ARDS, heart failure,renal failure and MODS. Conclusionsâ‘ In case of severe acute pancreatitis,the independent risk factors related to mortality were age,abdominal dropsy,ARDS,heart failure,renal failure and MODS.â‘¡The incidence of MODS was related with SAP tightly,and the death rate of SAP would increase with the MODS increasing.â‘¢CT scan of abdomen and chemistry data of blood(HCT,Ca²⁺,Cr,BG,PO₂,PCO₂,PH)can help us to judge the prognosis of SAP and to guide the clinic treatment.â‘£Operation was useless for increasing of the survival of SAP,but selecting proper time and operation modus was helpful for treatment of SAP.