Early onset of organ failure is the best predictor of mortality in acute pancreatitis
Background: APACHE II is a multifactorial scoring system for predicting severity in acute pancreatitis (AP). Organ failure (OF) has been correlated with mortality in AP. Objectives: to evaluate the usefulness of APACHE II as an early predictor of severity in AP, its correlation with OF, and the relevance of an early establishment of OF during the course of AP. Patients and methods: from January 1999 to November 2001, 447 consecutive cases of AP were studied. APACHE II scores and Atlanta criteria were used for defining severity and OF. Results: twenty-five percent of patients had severe acute pancreatitis (SAP). APACHE II at 24 h after admission showed a sensitivity, specificity, and positive and negative predictive value of 52, 77, 46, and 84%, respectively, for predicting severity. Mortality for SAP was 20.5%. Seventy percent of patients who developed OF did so within the first 24 hours of admission, and their mortality was 52%. Mortality was statistically significant (p < 0.01) if OF was established within the first 24 hours after admission. Conclusions: APACHE II is not reliable for predicting outcome within the first 24 hours after admission and should therefore be used together with other methods. OF mostly develops within the first days after admission, if ever. The time of onset of OF is the most accurate and reliable method for predicting death risk in AP.
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Sociedad Española de Patología Digestiva
2004
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oai:scielo:S1130-010820040010000052006-08-24Early onset of organ failure is the best predictor of mortality in acute pancreatitisPoves Prim,I.Fabregat Prous,J.García Borobia,F. J.Jorba Martí,R.Figueras Felip,J.Jaurrieta Mas,E. Severe acute pancreatitis Organ failure APACHE II Background: APACHE II is a multifactorial scoring system for predicting severity in acute pancreatitis (AP). Organ failure (OF) has been correlated with mortality in AP. Objectives: to evaluate the usefulness of APACHE II as an early predictor of severity in AP, its correlation with OF, and the relevance of an early establishment of OF during the course of AP. Patients and methods: from January 1999 to November 2001, 447 consecutive cases of AP were studied. APACHE II scores and Atlanta criteria were used for defining severity and OF. Results: twenty-five percent of patients had severe acute pancreatitis (SAP). APACHE II at 24 h after admission showed a sensitivity, specificity, and positive and negative predictive value of 52, 77, 46, and 84%, respectively, for predicting severity. Mortality for SAP was 20.5%. Seventy percent of patients who developed OF did so within the first 24 hours of admission, and their mortality was 52%. Mortality was statistically significant (p < 0.01) if OF was established within the first 24 hours after admission. Conclusions: APACHE II is not reliable for predicting outcome within the first 24 hours after admission and should therefore be used together with other methods. OF mostly develops within the first days after admission, if ever. The time of onset of OF is the most accurate and reliable method for predicting death risk in AP.Sociedad Española de Patología DigestivaRevista Española de Enfermedades Digestivas v.96 n.10 20042004-10-01journal articletext/htmlhttp://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082004001000005en |
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Poves Prim,I. Fabregat Prous,J. García Borobia,F. J. Jorba Martí,R. Figueras Felip,J. Jaurrieta Mas,E. |
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Poves Prim,I. Fabregat Prous,J. García Borobia,F. J. Jorba Martí,R. Figueras Felip,J. Jaurrieta Mas,E. Early onset of organ failure is the best predictor of mortality in acute pancreatitis |
| author_facet |
Poves Prim,I. Fabregat Prous,J. García Borobia,F. J. Jorba Martí,R. Figueras Felip,J. Jaurrieta Mas,E. |
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Poves Prim,I. |
| title |
Early onset of organ failure is the best predictor of mortality in acute pancreatitis |
| title_short |
Early onset of organ failure is the best predictor of mortality in acute pancreatitis |
| title_full |
Early onset of organ failure is the best predictor of mortality in acute pancreatitis |
| title_fullStr |
Early onset of organ failure is the best predictor of mortality in acute pancreatitis |
| title_full_unstemmed |
Early onset of organ failure is the best predictor of mortality in acute pancreatitis |
| title_sort |
early onset of organ failure is the best predictor of mortality in acute pancreatitis |
| description |
Background: APACHE II is a multifactorial scoring system for predicting severity in acute pancreatitis (AP). Organ failure (OF) has been correlated with mortality in AP. Objectives: to evaluate the usefulness of APACHE II as an early predictor of severity in AP, its correlation with OF, and the relevance of an early establishment of OF during the course of AP. Patients and methods: from January 1999 to November 2001, 447 consecutive cases of AP were studied. APACHE II scores and Atlanta criteria were used for defining severity and OF. Results: twenty-five percent of patients had severe acute pancreatitis (SAP). APACHE II at 24 h after admission showed a sensitivity, specificity, and positive and negative predictive value of 52, 77, 46, and 84%, respectively, for predicting severity. Mortality for SAP was 20.5%. Seventy percent of patients who developed OF did so within the first 24 hours of admission, and their mortality was 52%. Mortality was statistically significant (p < 0.01) if OF was established within the first 24 hours after admission. Conclusions: APACHE II is not reliable for predicting outcome within the first 24 hours after admission and should therefore be used together with other methods. OF mostly develops within the first days after admission, if ever. The time of onset of OF is the most accurate and reliable method for predicting death risk in AP. |
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Sociedad Española de Patología Digestiva |
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2004 |
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http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082004001000005 |
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