Tran et al identified factors associated with infection of necrotic tissue in a patient with severe acute pancreatitis. These can help to identify a patient with a worse prognosis. The authors are from the University of Ottawa, McMaster University and USC.
Patient selection: severe acute pancreatitis
Predictors:
(1) older age (OR 2.2)
(2) gallstone pancreatitis (OR 2.4)
(3) > 50% necrosis of the pancreas (OR 3.6)
(4) delay in starting enteral nutrition (OR 2.1)
(5) multi-organ failure (OR 11.7)
(6) invasive mechanical ventilation (OR 12.2)
where:
• Multi-organ failure and invasive mechanical ventilation may not be independent of each other.
The presence of multiple predictors increases the risk of infected necrosis.
The presence of infected necrosis increases the mortality rate at least two-fold.
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