Table of Contents
ISRN Surgery
Volume 2012, Article ID 215193, 5 pages
http://dx.doi.org/10.5402/2012/215193
Clinical Study

Correlates of Morbidity and Mortality in Severe Necrotizing Pancreatitis

1Department of Surgery, Aga Khan University, Karachi 74800, Pakistan
2Department of Radiology, Aga Khan University, Pakistan
3Department of Community Health Sciences, Aga Khan University, Pakistan

Received 2 April 2012; Accepted 16 May 2012

Academic Editors: S. Schulze and E. C. Tsimoyiannis

Copyright © 2012 K. M. Pal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute severe pancreatitis is associated with a high morbidity and mortality and frequently is accompanied by underlying pancreatic parenchymal necrosis. Patients with pancreatic necrosis must be identified, because the morbidity and mortality rate in this subgroup is much higher. Our objective was to compare the clinical outcomes of these patients based on the degree of pancreatic necrosis. A total of 35 patients were noted to have pancreatic necrosis. These were divided into 2 groups based on extent of necrosis: group A had less than 50% necrosis and group B had more than 50% necrosis. The rate of mortality (5% versus 40%) was significantly higher in group B. The rate of organ dysfunction also rose along with the rates of other morbidities and variables that were related to a patient’s hospital stay. Only APACHE II significantly correlated with the degree of necrosis, wherein the chances of substantial necrosis rose by 20% with each unit increase of APACHE II score. APACHE II Score could be employed and studied further prospectively to help identify patients with pancreatic necrosis.