Analysis and prevention of factors predisposing to infections associated with severe acute pancreatitis.

OBJECTIVE

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

METHODS

208 patients with SAP treated at our hospital from January 1986 to December 2001 were retrospectively analyzed.

RESULTS

Statistical difference in the incidence of the infections was found between the following pairs: the groups of bloody or non-bloody ascites, paralytic ileus lasting shorter or longer than 5 days, Ranson's scores lower or higher than 5, hematocrit lower or higher than 45%, CT Balthazar scores lower or higher than 7, and between January 1986-June 1992 or July 1992-December 2001 admissions (chi2>7.58, P<0.05), while no statistical difference established between the groups of biliogenic and non-biliogenic pancreatitis, serum amylase <200 U/L and >/=200 U/L, serum calcium <2 mmol/L and >/=2 mmol/L or groups of total parenteral nutrition shorter or longer than 7 days (chi2<1.61, P>0.05).

CONCLUSIONS

Occurrence of infection in patients with SAP is closely related with bloody ascites, paralytic ileus (>/=5 days), Ranson's scores (>/=5), hematocrit (>/=45%) and CT Balthazar scores (>/=7), but not with pathogenesis, serum calium or total parenteral nutrition. Comprehensive prevention of pancreatic infection and individualized therapy may reduce the incidence of infection.