Mäkelä Jyrki T, Eila Heinonen, Kiviniemi Heikki, Laurila Jouko, Laitinen Seppo
Department of Surgery, Division of Gastroenterology, PO Box 5000, 90014 University of Oulu, Oulu, Finland.
Am J Surg. 2007 Jul;194(1):30-4. doi: 10.1016/j.amjsurg.2006.08.089.
Severe acute pancreatitis is a multisystem disease in which various local and systemic complications lead to high mortality. We retrospectively examined the clinical and biochemical factors that may influence the risk of mortality on admission to emergency and intensive care units (ICUs).
Sixty-eight patients were admitted into our hospital for acute pancreatitis and treated in our ICU for computed tomography-proven severe acute pancreatitis during the years 1997 to 2004. The clinical, biochemical, and radiologic data were reviewed from the computerized database, radiologic films, and patient records.
The mortality rate during the ICU stay was 18% (12/68) and that during the whole period of hospitalization 26% (18/68). A C-reactive protein (CRP) value over 150 was the only independent predictor of mortality on admission into the emergency unit, whereas the computed tomography severity index and the elevated CRP value over 150 predicted significantly and independently mortality on admission into the ICU. Linear backward regression analysis showed that high CRP values and respiratory failure on ICU admission correlate with longer ICU stay. Men's ICU stays were longer than those of women.
A high computed tomography severity index and CRP values over 150 on admission into the ICU are valuable predictors of the mortality risk. High CRP, renal and respiratory failure, and male gender are associated with longer ICU stay.
重症急性胰腺炎是一种多系统疾病，各种局部和全身并发症会导致高死亡率。我们回顾性研究了可能影响急诊和重症监护病房（ICU）入院时死亡风险的临床和生化因素。
1997年至2004年间，68例因急性胰腺炎入院并在我院ICU接受治疗的患者，经计算机断层扫描证实为重症急性胰腺炎。从计算机数据库、放射影像和患者记录中回顾临床、生化和放射学数据。
ICU住院期间死亡率为18%（12/68），整个住院期间死亡率为26%（18/68）。入院时C反应蛋白（CRP）值超过150是急诊入院时死亡的唯一独立预测因素，而计算机断层扫描严重程度指数和CRP值超过150可显著且独立地预测ICU入院时的死亡率。线性向后回归分析表明，ICU入院时高CRP值和呼吸衰竭与ICU住院时间延长相关。男性在ICU的住院时间比女性长。
ICU入院时高计算机断层扫描严重程度指数和CRP值超过150是死亡风险的有价值预测指标。高CRP、肾和呼吸衰竭以及男性性别与ICU住院时间延长有关。
