Improved Outcome of Severe Acute Pancreatitis in the Intensive Care Unit
Background. Severe acute pancreatitis (SAP) is associated with serious morbidity and mortality. Our objective was to describe the case mix, management, and outcome of patients with SAP receiving modern critical care in the Intensive Care Unit (ICU). Methods. Retrospective analysis of patients with S...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2013/897107 |
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| author | Polychronis Pavlidis Siobhan Crichton Joanna Lemmich Smith David Morrison Simon Atkinson Duncan Wyncoll Marlies Ostermann |
| author_facet | Polychronis Pavlidis Siobhan Crichton Joanna Lemmich Smith David Morrison Simon Atkinson Duncan Wyncoll Marlies Ostermann |
| author_sort | Polychronis Pavlidis |
| collection | DOAJ |
| description | Background. Severe acute pancreatitis (SAP) is associated with serious morbidity and mortality. Our objective was to describe the case mix, management, and outcome of patients with SAP receiving modern critical care in the Intensive Care Unit (ICU). Methods. Retrospective analysis of patients with SAP admitted to the ICU in a single tertiary care centre in the UK between January 2005 and December 2010. Results. Fifty SAP patients were admitted to ICU (62% male, mean age 51.7 (SD 14.8)). The most common aetiologies were alcohol (40%) and gallstones (30%). On admission to ICU, the median Acute Physiology and Chronic Health Evaluation (APACHE) II score was 17, the pancreatitis outcome prediction score was 8, and the median Computed Tomography Severity Index (CTSI) was 4. Forty patients (80%) tolerated enteral nutrition, and 46% received antibiotics for non-SAP reasons. Acute kidney injury was significantly more common among hospital nonsurvivors compared to survivors (100% versus 42%, ). ICU mortality and hospital mortality were 16% and 20%, respectively, and median lengths of stay in ICU and hospital were 13.5 and 30 days, respectively. Among hospital survivors, 27.5% developed diabetes mellitus and 5% needed long-term renal replacement therapy. Conclusions. The outcome of patients with SAP in ICU was better than previously reported but associated with a resource demanding hospital stay and long-term morbidity. |
| format | Article |
| id | doaj-art-da06bc376c91452c862ea05391de4bb6 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-da06bc376c91452c862ea05391de4bb62025-02-03T06:08:25ZengWileyCritical Care Research and Practice2090-13052090-13132013-01-01201310.1155/2013/897107897107Improved Outcome of Severe Acute Pancreatitis in the Intensive Care UnitPolychronis Pavlidis0Siobhan Crichton1Joanna Lemmich Smith2David Morrison3Simon Atkinson4Duncan Wyncoll5Marlies Ostermann6Department of Critical Care, Guy’s and St Thomas' NHS Foundation Trust, King's College London, London SE1 7EH, UKDivision of Health and Social Care Research, King's College London, London SE1 3QD, UKDepartment of Critical Care, Guy’s and St Thomas' NHS Foundation Trust, King's College London, London SE1 7EH, UKDepartment of Abdominal Surgery, Guy's and St Thomas' NHS Foundation Trust, King’s College London, London SE1 7EH, UKDepartment of Abdominal Surgery, Guy's and St Thomas' NHS Foundation Trust, King’s College London, London SE1 7EH, UKDepartment of Critical Care, Guy’s and St Thomas' NHS Foundation Trust, King's College London, London SE1 7EH, UKDepartment of Critical Care, Guy’s and St Thomas' NHS Foundation Trust, King's College London, London SE1 7EH, UKBackground. Severe acute pancreatitis (SAP) is associated with serious morbidity and mortality. Our objective was to describe the case mix, management, and outcome of patients with SAP receiving modern critical care in the Intensive Care Unit (ICU). Methods. Retrospective analysis of patients with SAP admitted to the ICU in a single tertiary care centre in the UK between January 2005 and December 2010. Results. Fifty SAP patients were admitted to ICU (62% male, mean age 51.7 (SD 14.8)). The most common aetiologies were alcohol (40%) and gallstones (30%). On admission to ICU, the median Acute Physiology and Chronic Health Evaluation (APACHE) II score was 17, the pancreatitis outcome prediction score was 8, and the median Computed Tomography Severity Index (CTSI) was 4. Forty patients (80%) tolerated enteral nutrition, and 46% received antibiotics for non-SAP reasons. Acute kidney injury was significantly more common among hospital nonsurvivors compared to survivors (100% versus 42%, ). ICU mortality and hospital mortality were 16% and 20%, respectively, and median lengths of stay in ICU and hospital were 13.5 and 30 days, respectively. Among hospital survivors, 27.5% developed diabetes mellitus and 5% needed long-term renal replacement therapy. Conclusions. The outcome of patients with SAP in ICU was better than previously reported but associated with a resource demanding hospital stay and long-term morbidity.http://dx.doi.org/10.1155/2013/897107 |
| spellingShingle | Polychronis Pavlidis Siobhan Crichton Joanna Lemmich Smith David Morrison Simon Atkinson Duncan Wyncoll Marlies Ostermann Improved Outcome of Severe Acute Pancreatitis in the Intensive Care Unit Critical Care Research and Practice |
| title | Improved Outcome of Severe Acute Pancreatitis in the Intensive Care Unit |
| title_full | Improved Outcome of Severe Acute Pancreatitis in the Intensive Care Unit |
| title_fullStr | Improved Outcome of Severe Acute Pancreatitis in the Intensive Care Unit |
| title_full_unstemmed | Improved Outcome of Severe Acute Pancreatitis in the Intensive Care Unit |
| title_short | Improved Outcome of Severe Acute Pancreatitis in the Intensive Care Unit |
| title_sort | improved outcome of severe acute pancreatitis in the intensive care unit |
| url | http://dx.doi.org/10.1155/2013/897107 |
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