Indian Journal of Gastroenterology

, Volume 31, Issue 5, pp 243–252

Audit of patients with severe acute pancreatitis admitted to an intensive care unit

  • Ratender Kumar Singh
  • Banani Poddar
  • Arvind Kumar Baronia
  • Afzal Azim
  • Mohan Gurjar
  • Sanjay Singhal
  • Shilpi Srivastava
  • Saurabh Saigal
Original Article

DOI: 10.1007/s12664-012-0205-1

Cite this article as:
Singh, R.K., Poddar, B., Baronia, A.K. et al. Indian J Gastroenterol (2012) 31: 243. doi:10.1007/s12664-012-0205-1

Abstract

Background

Severe acute pancreatitis (SAP) is a disease with high morbidity and mortality. We undertook a study of patients with SAP admitted to the intensive care unit (ICU) of a tertiary referral hospital.

Methods

Between 2002 and 2007, 50 patients with SAP were admitted in our intensive care unit (ICU). Data were collected from their medical records and their clinical profile, course and outcome were retrospectively analyzed. Patients were categorized into survivor and nonsurvivor groups, and were further classified based on interventions such as percutaneous drainage and surgical necrosectomy.

Results

SAP contributed 5 % of total ICU admissions during the study period. Median age of survivors (n = 20) was 34 against 44 years in nonsurvivors (n = 30). Median Acute Physiology and Chronic Health Evaluation (APACHE) II score in nonsurvivors was 16.5 (8–32) vs. 12.5 (5–20) in survivors (p = 0.002). Patients with APACHE II score ≥12 had mortality >80 % compared to 23 % with score <12 (p < 0.001). Median Sequential Organ Failure Assessment (SOFA) scores on admission and on days 3, 7, 14, and 21 were significantly higher in nonsurvivors compared to survivors (p < 0.05). Mean (SD) intraabdominal pressure was 23 (3.37) mmHg in nonsurvivors vs. 19.05 (2.51) in survivors (p < 0.05). Patients with renal failure had significant mortality (p < 0.001). Length of ICU stay, requirement for vasopressor, total parenteral nutrition, and the amount of blood and blood product transfusions differed significantly between patients with and without intervention.

Conclusions

APACHE II and SOFA scores and other clinical data correlated with outcome in SAP admitted to ICU.

Keywords

Severe acute pancreatitis Acute physiology and chronic health evaluation score Sequential organ failure assessment score Percutaneous drainage Necrosectomy 

Copyright information

© Indian Society of Gastroenterology 2012

Authors and Affiliations

  • Ratender Kumar Singh
    • 1
  • Banani Poddar
    • 1
  • Arvind Kumar Baronia
    • 1
  • Afzal Azim
    • 1
  • Mohan Gurjar
    • 1
  • Sanjay Singhal
    • 1
  • Shilpi Srivastava
    • 1
  • Saurabh Saigal
    • 1
  1. 1.Department of Critical Care MedicineSanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia