This study was presented in part at the European Pancreatic Club Meeting, Newcastle-upon-Tyne, 5–6 July 2007.
Incidence of individual organ dysfunction in fatal acute pancreatitis: analysis of 1024 death records
Article first published online: 17 MAR 2009
© 2009 International Hepato-Pancreato-Biliary Association
Volume 11, Issue 2, pages 166–170, March 2009
How to Cite
Mole, D. J., Olabi, B., Robinson, V., Garden, O. J. and Parks, R. W. (2009), Incidence of individual organ dysfunction in fatal acute pancreatitis: analysis of 1024 death records. HPB, 11: 166–170. doi: 10.1111/j.1477-2574.2009.00038.x
- Issue published online: 17 MAR 2009
- Article first published online: 17 MAR 2009
- Received 28 November 2008; accepted 17 January 2009
- acute pancreatitis;
- multi-organ failure;
Background: Extrapancreatic organ dysfunction is the key determinant of mortality in acute pancreatitis (AP). This study aimed to document the frequency and duration of individual organ dysfunction in all fatalities caused by AP in a large, population-based cohort.
Methods: All deaths caused by AP in Scotland between 2000 and 2006 inclusive were analysed (n = 1024).
Results: The median time lapse between the onset of AP and death was 6 days (interquartile range [IQR] 17 days); that between the onset of organ dysfunction and death was 3 days (IQR 7 days). There was no apparent bimodal distribution. The majority of patients had single- (384 patients) or two-system (242 patients) extrapancreatic organ dysfunction. Pulmonary dysfunction was most prevalent (30% of organ-specific entries, 198/660), followed by cardiovascular (18%, 117/660), renal (16%, 108/660), liver (11%, 71/660), gastrointestinal (9%, 59/660), haemorrhage (6%, 38/660), coagulopathy (5%, 31/660) and central nervous system (6%, 38/660) dysfunction.
Conclusions: Death in AP occurs early in the disease course. The present findings support the primacy of pulmonary injury as the modal pattern of organ dysfunction in severe AP, with increased frequencies of cardiovascular and renal compromise in fatal AP.