Banerjee A K, Kaul A, Bache E, Parberry A C, Doran J, Nicholson M L
Department of Surgery, Queen's Medical Centre, Nottingham, UK.
Postgrad Med J. 1995 Aug;71(838):472-5. doi: 10.1136/pgmj.71.838.472.
Acute pancreatitis has a mortality of about 10%: this figure has not changed over the last 20 years. A retrospective audit of fatal acute pancreatitis was performed in a teaching hospital with a catchment population of about 750,000 patients to examine patient characteristics. Using Hospital Activity Analysis code 577.0, all fatal cases of acute pancreatitis were studied in a six-year period 1987-93. Additionally, all post mortem diagnoses of acute pancreatitis were traced. The overall post mortem rate in Nottingham at the time of the study was about 35%. All available records, X-ray and biochemical data were studied and appropriate information recorded and analysed for 65 fatal cases. Only 15% were post mortem diagnoses, lower than in previous series; 72% had respiratory and 67% had renal complications. Only 34% had been admitted to the intensive care unit. A third of patients had had surgery; 67% of these was some form of external drainage. Of the 14 patients with proven gallstone pancreatitis only three had endoscopic retrograde cholangiopancreatography; 42% of patients had idiopathic disease. Not all the patients diagnosed ante mortem had the full biochemical predicted severity criteria analysed: pO2 and calcium analysis was performed in about 80%. Pre-mortem diagnoses of pancreatitis was achieved more frequently than in other comparable series.
急性胰腺炎的死亡率约为10%：在过去20年中这一数字并未改变。在一所服务人口约75万患者的教学医院对致命性急性胰腺炎进行了一项回顾性审计，以研究患者特征。使用医院活动分析代码577.0，对1987 - 1993年六年期间所有急性胰腺炎死亡病例进行了研究。此外，还追踪了所有急性胰腺炎的尸检诊断。研究时诺丁汉的总体尸检率约为35%。对65例死亡病例的所有可用记录、X线和生化数据进行了研究，并记录和分析了适当的信息。只有15%是尸检诊断，低于先前系列；72%有呼吸并发症，67%有肾脏并发症。只有34%的患者入住了重症监护病房。三分之一的患者接受了手术；其中67%是某种形式的外引流。在14例经证实为胆石性胰腺炎的患者中，只有3例进行了内镜逆行胰胆管造影；42%的患者患有特发性疾病。并非所有生前诊断的患者都对完整的生化预测严重程度标准进行了分析：约80%的患者进行了动脉血氧分压和钙分析。胰腺炎的生前诊断比其他类似系列更为常见。
