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Predictors for mortality following acute pancreatitis in children

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Abstract

Introduction

Although there are several studies focusing on pancreatitis etiology and clinical outcome, no previous report has examined the risk factors for death in children.

Patients and methods

We reviewed the medical records of all children (ages 0–18 years) admitted to West China Hospital with acute pancreatitis between 2002 and 2012. Independent predictors for death following acute pancreatitis in children were identified using a multivariate logistic regression analysis.

Results

Biliary diseases (23 %), medications (20 %), idiopathic (19 %), and trauma (11 %) were the most common etiologies for acute pancreatitis in children. The death rate was 5 % and the mean duration of hospital stay was 13 days. Organ failure during admission occurred in 24 of 371 patients and most of them started in 3 days of onset (19/24). Multivariate analysis with logistic regression confirmed that occurrence of SIRS in the first week of onset (OR = 2.12, 95 % CI 1.14–6.32, P < 0.001), occurrence of organ failure within 3 days of onset (OR = 8.0, 95 % CI 2.2–12.3, P < 0.001), occurrence of MOF in the first week of onset (OR = 9.4, 95 % CI 2.3–14.6, P < 0.001), infected necrosis (OR = 1.28, 95 % CI 1.08–1.52, P = 0.02), and idiopathic cause (OR = 17.3, 95 % CI 2.0–60.5, P < 0.001) were independent risk factors for death in cases with pancreatitis.

Conclusions

Mortality rate and complication rate of acute pancreatitis in children remains low. Patients with SIRS, early organ failure, MOF, infected necrosis, or idiopathic cause should be well evaluated because they have higher risk of death.

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Acknowledgments

All of the authors contributed to the collection and analysis of the data and to the preparation of the report. The corresponding author had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Part of the study was presented at the 44th Annual Meeting of American Pancreatic Association 2013 (October 30–November 2, Miami, FL, USA).

Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Hepato-Bilio-Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Qiang Guo, Mao Li, Yang Chen, Hankui Hu & Weiming Hu

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  1. Qiang Guo
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  2. Mao Li
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  3. Yang Chen
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  4. Hankui Hu
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  5. Weiming Hu
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Correspondence to Weiming Hu.

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Guo, Q., Li, M., Chen, Y. et al. Predictors for mortality following acute pancreatitis in children. Pediatr Surg Int 30, 1111–1115 (2014). https://doi.org/10.1007/s00383-014-3595-6

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  • DOI: https://doi.org/10.1007/s00383-014-3595-6

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