急性胰腺炎的死亡是发生在早期还是晚期?

M Mutinga, A Rosenbluth, S M Tenner, R R Odze, G T Sica, P A Banks
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引用次数: 132

摘要

未标记:先前的几项研究表明,80%的急性胰腺炎死亡是由泛胰腺感染引起的。另一些人认为,由于多系统器官衰竭,大约一半的死亡发生在早期。本研究的目的是确定美国一家大型三级医院急性胰腺炎的死亡时间。方法:回顾性分析1982年10月1日至1995年6月30日布里格姆妇女医院(Brigham and Women's Hospital)诊断为急性胰腺炎(ICD-9代码577.0)的患者,确定其总死亡率、早期与晚期死亡的频率,以及早期(<或=入院后14 d)或晚期死亡(>入院后14 d)患者的临床特征。结果:急性胰腺炎总死亡率为2.1%(805例患者中死亡17例)。8例死亡(47%)发生在住院的前14天内(中位数d 8,范围1-11天),而9例死亡发生在14天之后(中位数d 56,范围19-81)。早期死亡主要是由于器官衰竭。感染性或无菌性坏死8例术后死亡,内科治疗感染性坏死1例。结论:大约一半的急性胰腺炎死亡发生在最初14天内,原因是器官衰竭,其余的死亡发生在之后,原因是坏死性胰腺炎相关的并发症。未来死亡率的提高将需要创新的方法来对抗早期器官衰竭和坏死性胰腺炎的晚期并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Does mortality occur early or late in acute pancreatitis?

Unlabelled: Several prior studies have suggested that 80% of deaths in acute pancreatitis occur late as a result of pan-creatic infection. Others have suggested that approx half of deaths occur early as a result of multisystem organ failure. The aim of the present study was to determine the timing of mortality of acute pancreatitis at a large tertiary-care hospital in the United States.

Methods: Patients with a diagnosis of acute pancreatitis (ICD-9 code 577.0) admitted to Brigham and Women's Hospital from October 1, 1982 to June 30, 1995 were retrospectively studied to determine total mortality, frequency of early vs late deaths, and clinical features of patients with early (< or = 14 d after admission) or late deaths (> 14 d after admission).

Results: The overall mortality of acute pancreatitis was 2.1% (17 deaths among 805 patients). Eight deaths (47%) occurred within the first 14 d of hospitalization (median d 8, range 1-11 d), whereas 9 occurred after 14 d (median d 56, range 19-81). Early deaths resulted primarily from organ failure. Late deaths occurred postoperatively in 8 patients with infected or sterile necrosis and 1 patient with infected necrosis treated medically.

Conclusion: Approximately half of deaths in acute pancreatitis occur within the first 14 d owing to organ failure and the remainder of deaths occur later because of complications associated with necrotizing pancreatitis. Improvement in mortality in the future will require innovative approaches to counteract early organ failure and late complications of necrotizing pancreatitis.

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