Analysis of the factors that affect the mortality rate in severe acute pancreatitis

Beomjae Lee, Chang Duck Kim, Sung Woo Jung, Yong Dae Kwon, Yong Sik Kim, Hyung Joon Yim, Yoon Tae Jeen, Hong Sik Lee, Jae Seon Kim, Hoon-Jai Chun, Soon-Ho Um, Sang Woo Lee, Jai Hyun Choi, Ho Sang Ryu

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Abstract

BACKGROUND/AIMS: Severe acute pancreatitis occurs in about 20% of the patients with acute pancreatitis and can be associated with multiorgan failure and local complications. In patients with predicted severe acute pancreatitis, overall mortality rates are about 15-30%. The aim of this study was to determine the factors correlated with mortality in patients with severe acute pancreatitis. METHODS: We reviewed five hundread and seventy two consecutive cases of acute pancreatitis from January, 2000 to December, 2005. Of them, 109 patients who fulfilled the criteria of Atlanta classification for severe acute pancreatitis were enrolled. Data were collected by chart reviews including age, gender, etiology, body mass index (BMI), modified Glasgow score, APACHE II score, APACHE III score, Balthazar CT index, and other laboratory parameters performed within 48 hours after the initial admission. RESULTS: Severe acute pancreatitis was most commonly caused by alcohol. Overall mortality rate was 20.2% in severe acute pancreatitis and 10 (45%) deaths occurred within the first week. Multiple logistic regression analysis identified serum creatinine, corrected calcium concentrations, and CT index as predictors of mortality in patients with severe acute pancreatitis. The risk score (R) was calculated by combining 3 prognostic values with regression coefficients; R=2.512 loge (creatinine mg/dL)+1.729 loge (CT index)??4.780 loge (corrected calcium mg/dL). The AUC for this score was 0.877 and a cutoff level of 0 was determined to predict the mortality with 83.3% sensitivity and 89.5% specificity. CONCLUSIONS: The newly designed risk score comprising 3 parameters can be used as the significant early predictor for hospital mortality in severe acute pancreatitis.

Original languageEnglish
Pages (from-to)25-33
Number of pages9
JournalThe Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
Volume51
Issue number1
Publication statusPublished - 2008 Jan 1

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Pancreatitis
Statistical Factor Analysis
Mortality
APACHE
Creatinine
Calcium
Hospital Mortality
Area Under Curve
Body Mass Index
Logistic Models
Regression Analysis
Alcohols
Sensitivity and Specificity
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{1156fd936a5042139553576cd685c11f,
title = "Analysis of the factors that affect the mortality rate in severe acute pancreatitis",
abstract = "BACKGROUND/AIMS: Severe acute pancreatitis occurs in about 20{\%} of the patients with acute pancreatitis and can be associated with multiorgan failure and local complications. In patients with predicted severe acute pancreatitis, overall mortality rates are about 15-30{\%}. The aim of this study was to determine the factors correlated with mortality in patients with severe acute pancreatitis. METHODS: We reviewed five hundread and seventy two consecutive cases of acute pancreatitis from January, 2000 to December, 2005. Of them, 109 patients who fulfilled the criteria of Atlanta classification for severe acute pancreatitis were enrolled. Data were collected by chart reviews including age, gender, etiology, body mass index (BMI), modified Glasgow score, APACHE II score, APACHE III score, Balthazar CT index, and other laboratory parameters performed within 48 hours after the initial admission. RESULTS: Severe acute pancreatitis was most commonly caused by alcohol. Overall mortality rate was 20.2{\%} in severe acute pancreatitis and 10 (45{\%}) deaths occurred within the first week. Multiple logistic regression analysis identified serum creatinine, corrected calcium concentrations, and CT index as predictors of mortality in patients with severe acute pancreatitis. The risk score (R) was calculated by combining 3 prognostic values with regression coefficients; R=2.512 loge (creatinine mg/dL)+1.729 loge (CT index)??4.780 loge (corrected calcium mg/dL). The AUC for this score was 0.877 and a cutoff level of 0 was determined to predict the mortality with 83.3{\%} sensitivity and 89.5{\%} specificity. CONCLUSIONS: The newly designed risk score comprising 3 parameters can be used as the significant early predictor for hospital mortality in severe acute pancreatitis.",
author = "Beomjae Lee and Kim, {Chang Duck} and Jung, {Sung Woo} and Kwon, {Yong Dae} and Kim, {Yong Sik} and Yim, {Hyung Joon} and Jeen, {Yoon Tae} and Lee, {Hong Sik} and Kim, {Jae Seon} and Hoon-Jai Chun and Soon-Ho Um and Lee, {Sang Woo} and Choi, {Jai Hyun} and Ryu, {Ho Sang}",
year = "2008",
month = "1",
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language = "English",
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pages = "25--33",
journal = "The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi",
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T1 - Analysis of the factors that affect the mortality rate in severe acute pancreatitis

AU - Lee, Beomjae

AU - Kim, Chang Duck

AU - Jung, Sung Woo

AU - Kwon, Yong Dae

AU - Kim, Yong Sik

AU - Yim, Hyung Joon

AU - Jeen, Yoon Tae

AU - Lee, Hong Sik

AU - Kim, Jae Seon

AU - Chun, Hoon-Jai

AU - Um, Soon-Ho

AU - Lee, Sang Woo

AU - Choi, Jai Hyun

AU - Ryu, Ho Sang

PY - 2008/1/1

Y1 - 2008/1/1

N2 - BACKGROUND/AIMS: Severe acute pancreatitis occurs in about 20% of the patients with acute pancreatitis and can be associated with multiorgan failure and local complications. In patients with predicted severe acute pancreatitis, overall mortality rates are about 15-30%. The aim of this study was to determine the factors correlated with mortality in patients with severe acute pancreatitis. METHODS: We reviewed five hundread and seventy two consecutive cases of acute pancreatitis from January, 2000 to December, 2005. Of them, 109 patients who fulfilled the criteria of Atlanta classification for severe acute pancreatitis were enrolled. Data were collected by chart reviews including age, gender, etiology, body mass index (BMI), modified Glasgow score, APACHE II score, APACHE III score, Balthazar CT index, and other laboratory parameters performed within 48 hours after the initial admission. RESULTS: Severe acute pancreatitis was most commonly caused by alcohol. Overall mortality rate was 20.2% in severe acute pancreatitis and 10 (45%) deaths occurred within the first week. Multiple logistic regression analysis identified serum creatinine, corrected calcium concentrations, and CT index as predictors of mortality in patients with severe acute pancreatitis. The risk score (R) was calculated by combining 3 prognostic values with regression coefficients; R=2.512 loge (creatinine mg/dL)+1.729 loge (CT index)??4.780 loge (corrected calcium mg/dL). The AUC for this score was 0.877 and a cutoff level of 0 was determined to predict the mortality with 83.3% sensitivity and 89.5% specificity. CONCLUSIONS: The newly designed risk score comprising 3 parameters can be used as the significant early predictor for hospital mortality in severe acute pancreatitis.

AB - BACKGROUND/AIMS: Severe acute pancreatitis occurs in about 20% of the patients with acute pancreatitis and can be associated with multiorgan failure and local complications. In patients with predicted severe acute pancreatitis, overall mortality rates are about 15-30%. The aim of this study was to determine the factors correlated with mortality in patients with severe acute pancreatitis. METHODS: We reviewed five hundread and seventy two consecutive cases of acute pancreatitis from January, 2000 to December, 2005. Of them, 109 patients who fulfilled the criteria of Atlanta classification for severe acute pancreatitis were enrolled. Data were collected by chart reviews including age, gender, etiology, body mass index (BMI), modified Glasgow score, APACHE II score, APACHE III score, Balthazar CT index, and other laboratory parameters performed within 48 hours after the initial admission. RESULTS: Severe acute pancreatitis was most commonly caused by alcohol. Overall mortality rate was 20.2% in severe acute pancreatitis and 10 (45%) deaths occurred within the first week. Multiple logistic regression analysis identified serum creatinine, corrected calcium concentrations, and CT index as predictors of mortality in patients with severe acute pancreatitis. The risk score (R) was calculated by combining 3 prognostic values with regression coefficients; R=2.512 loge (creatinine mg/dL)+1.729 loge (CT index)??4.780 loge (corrected calcium mg/dL). The AUC for this score was 0.877 and a cutoff level of 0 was determined to predict the mortality with 83.3% sensitivity and 89.5% specificity. CONCLUSIONS: The newly designed risk score comprising 3 parameters can be used as the significant early predictor for hospital mortality in severe acute pancreatitis.

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C2 - 18349559

AN - SCOPUS:58149125535

VL - 51

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JO - The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi

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