Factors predisposing to severe acute pancreatitis: evaluation and prevention.

AIM

To analyze factors predisposing to the infections associated with severe acute pancreatitis (SAP) and to work out ways for its prevention.

METHODS

Total 208 cases of SAP treated in this hospital from Jan. 1980 to Dec. 2001 were retrospectively analyzed.

RESULTS

Statistical difference in the incidence of the aforementioned infections was found between the following pairs: between the groups of bloody or non-bloody ascites, paralytic ileus lasting shorter or longer than 5 days, Ranson scores lower or higher than 5, hematocrit lower or higher than 45 %, CT Balthazar scores lower or higher than 7 and between 1980.1-1992.6 or 1992.7-2001.12 admissions (chi(2)>3.84, P<0.05), while no statistical difference was established between the groups of biliogenic and non - biliogenic pancreatitis, serum amylase <200 U/L and > or =200 U/L, serum calcium <2 mmol /L and > or =2 mmol/L or groups of total parenteral nutrition shorter or longer than 7 days (chi(2)<3.84, P>0.05).

CONCLUSION

Occurrence of infection in patients with SAP is closely related with bloody ascites, paralytic ileus > or =5 days, Ranson scores > or =5, hematocrit > or =45 % and CT Balthazar Scores > or =7, but not with pathogens, serum calcium and total parenteral nutrition (TPN). Comprehensive prevention of pancreatic infection and practice of individualized therapy contribute to reducing the incidence of infection.