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Risk Factors and Outcomes of Infectious Pancreatic Necrosis in Patients with Severe Acute Pancreatitis |
LIU Yan, WANG Chunhui, ZHANG Mingguang, et al |
West China Hospital, Sichuan University, Sichuan Chengdu 610041, China |
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Abstract Objective: To study the risk factors of infective pancreatic necrosis in patients with severe acute pancreatitis (SAP) and to explore their effects on prognosis. Methods: The clinical data of 319 patients with SAP in our hospital were retrospectively analyzed. According to whether pancreatic infection occurred, they were divided into infection group (n=62) and non-infection group (n=257). Clinical data of basic information, etiology, disease course, symptoms and signs, occurrence of complications, laboratory results, organ system function score and corresponding treatment measures were collected in the two group and compared and analyzed. The treatment effects of the two groups were followed up, and the condition changes and prognosis were compared between the two groups. Results: Among 319 patients with SAP, 62 cases (19.44%) were complicated with pancreatic infection, and the univariate analysis showed that there were statistically significant differences in the disease course, hypoxemia, MOF, extra-pancreatic infection, WBC, CRP, APACHE II score, fasting time and mechanical ventilation and antibiotic application between infection group and non-infection group (P<0.05). Logistic regression analysis showed that the disease course, hypoxemia, MOF, extra-pancreatic infection, fasting time and mechanical ventilation were independent risk factors for pancreatic infection in SAP (P<0.05), and antibiotic applicationwasan effective protective factor (P<0.05). The case mortality of infection group and non-infection group were 25.81% and 4.28% respectively(P<0.05). Conclusions: SAP complicated with infectiouspancreatic necrosis can significantly increase the mortality risk of patients. And its independent risk factors include disease course, hypoxemia, MOF, extra-pancreatic infection, fasting time and mechanical ventilation, and its protective factor is preventive application of antibiotics.
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