Factors predisposing to severe acute pancreatitis: evaluation and prevention

Abstract

Aim: To analyze factors predisposing to the infections associated with severe acute pancreatitis (SAP) and to work out ways for its prevention.

Methods: Total 208 cases of SAP treated in this hospital from Jan. 1980 to Dec. 2001 were retrospectively analyzed.

Results: Statistical difference in the incidence of the aforementioned infections was found between the following pairs: between the groups of bloody or non-bloody ascites, paralytic ileus lasting shorter or longer than 5 days, Ranson scores lower or higher than 5, hematocrit lower or higher than 45 %, CT Balthazar scores lower or higher than 7 and between 1980.1-1992.6 or 1992.7-2001.12 admissions (chi(2)>3.84, P<0.05), while no statistical difference was established between the groups of biliogenic and non - biliogenic pancreatitis, serum amylase <200 U/L and > or =200 U/L, serum calcium <2 mmol /L and > or =2 mmol/L or groups of total parenteral nutrition shorter or longer than 7 days (chi(2)<3.84, P>0.05).

Conclusion: Occurrence of infection in patients with SAP is closely related with bloody ascites, paralytic ileus > or =5 days, Ranson scores > or =5, hematocrit > or =45 % and CT Balthazar Scores > or =7, but not with pathogens, serum calcium and total parenteral nutrition (TPN). Comprehensive prevention of pancreatic infection and practice of individualized therapy contribute to reducing the incidence of infection.