MULTICENTER AUDIT OF DEATH FROM ACUTE-PANCREATITIS

被引:165
作者
MANN, DV [1 ]
HERSHMAN, MJ [1 ]
HITTINGER, R [1 ]
GLAZER, G [1 ]
机构
[1] ST MARYS HOSP,DEPT SURG,LONDON W2 1NY,ENGLAND
关键词
D O I
10.1002/bjs.1800810632
中图分类号
R61 [外科手术学];
学科分类号
摘要
A prospective audit of acute pancreatitis involving nine hospitals in the North-West Thames Region recruited 631 patients over 54 months. There were 57 deaths (9 per cent); a diagnosis had been reached in 50 patients (88 per cent) before death and in seven (12 per cent) at autopsy. Eighteen patients (32 per cent) died within the first week, usually as a result of multisystem organ failure (15 patients). Thirty-nine patients (68 per cent) died after the first week from complications related to infection (26 patients), co-morbid conditions (nine) or non-infective complications (four). Twenty-one patients (42 per cent) had been inadequately evaluated by Ranson's criteria, and only 22 (44 per cent) of 50 with a premortem diagnosis of pancreatitis had undergone computed tomography (CT). Fifteen of 26 patients who died from infection-related complications had CT and only nine underwent necrosectomy or surgical drainage. These data suggest that improved diagnosis, investigation and management of patients with acute pancreatitis is possible, and may result in improved clinical outcome.
引用
收藏
页码:890 / 893
页数:4
相关论文
共 47 条
[1]   INCIDENCE OF NECROTIZING PANCREATITIS AND FACTORS RELATED TO MORTALITY [J].
ALLARDYCE, DB .
AMERICAN JOURNAL OF SURGERY, 1987, 154 (03) :295-299
[2]  
[Anonymous], 1977, Lancet, V2, P632
[3]   ACUTE-PANCREATITIS - VALUE OF CT IN ESTABLISHING PROGNOSIS [J].
BALTHAZAR, EJ ;
ROBINSON, DL ;
MEGIBOW, AJ ;
RANSON, JHC .
RADIOLOGY, 1990, 174 (02) :331-336
[4]   PANCREATIC-ABSCESS AND OTHER PUS-HARBORING COLLECTIONS RELATED TO PANCREATITIS - A REVIEW OF 108 CASES [J].
BASSI, C ;
VESENTINI, S ;
NIFOSI, F ;
GIRELLI, R ;
FALCONI, M ;
ELIO, A ;
PEDERZOLI, P .
WORLD JOURNAL OF SURGERY, 1990, 14 (04) :505-512
[5]   NECROSECTOMY AND POSTOPERATIVE LOCAL LAVAGE IN NECROTIZING PANCREATITIS [J].
BEGER, HG ;
BUCHLER, M ;
BITTNER, R ;
BLOCK, S ;
NEVALAINEN, T ;
ROSCHER, R .
BRITISH JOURNAL OF SURGERY, 1988, 75 (03) :207-212
[6]   BACTERIAL-CONTAMINATION OF PANCREATIC NECROSIS - A PROSPECTIVE CLINICAL-STUDY [J].
BEGER, HG ;
BITTNER, R ;
BLOCK, S ;
BUCHLER, M .
GASTROENTEROLOGY, 1986, 91 (02) :433-438
[7]   PANCREATIC-ABSCESS AND INFECTED PANCREATIC NECROSIS - DIFFERENT LOCAL SEPTIC COMPLICATIONS IN ACUTE-PANCREATITIS [J].
BITTNER, R ;
BLOCK, S ;
BUCHLER, M ;
BEGER, HG .
DIGESTIVE DISEASES AND SCIENCES, 1987, 32 (10) :1082-1087
[8]   INCIDENCE AND MORTALITY OF ACUTE-PANCREATITIS [J].
BOURKE, JB .
BRITISH MEDICAL JOURNAL, 1977, 2 (6103) :1668-1669
[9]   MANAGEMENT OF INFECTED PANCREATIC NECROSIS BY OPEN DRAINAGE [J].
BRADLEY, EL .
ANNALS OF SURGERY, 1987, 206 (04) :542-550
[10]   A PROSPECTIVE LONGITUDINAL-STUDY OF OBSERVATION VERSUS SURGICAL INTERVENTION IN THE MANAGEMENT OF NECROTIZING PANCREATITIS [J].
BRADLEY, EL ;
ALLEN, K .
AMERICAN JOURNAL OF SURGERY, 1991, 161 (01) :19-25