Clinical characteristics and risk factors of organ failure and death in necrotizing pancreatitis

Abstract

Background: Organ failure (OF) and death are considered the most significant adverse outcome in necrotizing pancreatitis (NP). However, there are few NP-related studies describing the clinical traits of OF and aggravated outcomes. Purpose: Our objective was not only to address the risk factors of OF and death in NP patients, but further identify simple parameters that can discriminate high-risk patients of NP to improve outcomes. Methods: We performed a study of 432 NP patients from May 2017 to December 2021. All patients with NP were followed for 36 months. The primary end point was risk factors of OF and death in NP patients. The risk factors that were evaluated by logistic regression analysis. Results: Patients of NP with OF or death were generally older, higher APACHE II score, longer hospital stay, longer ICU stay, as well as a higher incidence of severe acute pancreatitis (SAP), shock and pancreatic necrosis. Independent risk factors related to OF included BMI, APACHE II score and SAP (P < 0.05). Age, shock and APACHE II score (P < 0.05) were the most significant factors correlated with the risk of death in NP patients. Notably, increased mortality was linked to the number of failed organs. Conclusions: NP is a potentially fatal disease with a longer hospital or ICU stay. Our study reported that the incidence of OF and death in NP patients are 69.9% and 10.2%, respectively. BMI, SAP, APACHE II score, age and shock could be the risk factors of OF and death in NP patients. Clinicians should focus on these factors for early diagnosis and appropriate therapy.