Poddar et al identified predictors for mortality in a patient with severe acute pancreatitis admitted to the intensive care unit (ICU). These can help identify a patient who may benefit from more aggressive management. The authors are from the Postgraduate Institute of Medical Sciences in Lucknow, India.


Mortality risk factors:

(1) body weight > 70 kilograms

(2) higher APACHE II score on admission (>= 17)

(3) multiple organ failures

(4) necrosis involving > 50% of the pancreas on CT scan


Organ failures include:

(1) respiratory, with need for mechanical ventilation

(2) cardiac, with need for vasopressors and inotropes

(3) renal (especially if present on admission)


A significant drop in the APACHE II score at 24 hours after admission is associated with a good prognosis. Survivors had a change of -11 from admission to the score at 24 hours.


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