Abstract：
BACKGROUND:A proportion of patients with acute pancreatitis (AP) develop necrosis. Around a third will become infected, and this is associated with a significant requirement for intervention and support. We evaluated the burden of necrotizing pancreatitis (NP) in an Australian tertiary hospital with regards to morbidity, mortality and resource consumption. METHODS:This is a retrospective case series of patients with AP admitted for at least 5 days to identify those with NP between 2009 and 2014. Data were analysed in groups according to the determinant-based classification of AP severity. RESULTS:Of 1339 patients with AP, 546 stayed 5 days or longer, and 38 had necrosis. Overall mortality for those with necrosis was 10.5% (4/38). Infection complicated necrosis in 45% (17/38). Organ failure also occurred in 45% (17/38) of patients with necrosis. All patients in the critical category and severe category required admission to the intensive care unit for a median of 21 and 12 days, respectively. A total of 90% of patients with critical category disease developed multi-organ failure, whereas most with severe category disease developed single organ failure only. Overall length of stay increased with increasing severity of disease. Intervention was required in 82% of infected necrosis (median 4 procedures). Those without infection also required multiple radiological investigations (median 7). CONCLUSION:Necrosis is uncommon in our cohort but is associated with a significant health-care burden. Almost half the patients with necrosis develop organ failure requiring prolonged hospital and intensive care unit stay. Patients require multiple investigations and interventions for infected necrosis. NP remains a costly, morbid disease in our society.
journal_name
ANZ J Surgjournal_title
ANZ journal of surgeryauthors
Shilton H,Breen D,Gupta S,Evans P,Pilgrim Cdoi
10.1111/ans.13883subject
Has Abstractpub_date
2018-03-01 00:00:00pages
E162-E166issue
3eissn
1445-1433issn
1445-2197journal_volume
88pub_type
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journal_title：ANZ journal of surgery
pub_type： 历史文章,杂志文章
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journal_title：ANZ journal of surgery
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journal_title：ANZ journal of surgery
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pub_type： 杂志文章,评审
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更新日期：2008-01-01 00:00:00
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pub_type： 杂志文章
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更新日期：2018-01-01 00:00:00
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