Document Detail

Acute pancreatitis: analysis of factors influencing survival.
MedLine Citation:
PMID:  831635     Owner:  NLM     Status:  MEDLINE    
Of patients with acute pancreatitis (AP), there remains a group who suffer life-threatening complications despite current modes of therapy. To identify factors which distinguish this group from the entire patient population, a retrospectiva analysis of 519 cases of AP occurring over a 5-year period was undertaken. Thirty-one per cent of these patients had a history of alcoholism and 47% had a history of biliary disease. The overall mortality was 12.9%. Of symptoms and signs recorded at the time of admission, hypotension, tachycardia, fever, abdominal mass, and abnormal examination of the lung fields correlated positively with increased mortality. Seven features of the initial laboratory examination correlated with increased mortality. Shock, massive colloid requirement, hypocalcemia, renal failure, and respiratory failure requiring endotracheal intubation were complications associated with the poorest prognosis. Among patients in this series with three or more of these clinical characteristics, maximal nonoperative treatment yielded a survival rate of 29%, compared to the 64% survival rate for a group of patients treated operatively with cholecystostomy, gastrostomy, feeding jejunostomy, and sump drainage of the lesser sac and retroperitoneum.
M L Jacobs; W M Daggett; J M Civette; M A Vasu; D W Lawson; A L Warshaw; G L Nardi; M K Bartlett
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  185     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1977 Jan 
Date Detail:
Created Date:  1977-02-26     Completed Date:  1977-02-26     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  43-51     Citation Subset:  AIM; IM    
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MeSH Terms
Acute Disease
Alcoholism / complications
Biliary Tract Diseases / complications
Child, Preschool
Hypocalcemia / complications
Hypotension / complications
Kidney Failure, Acute / complications
Middle Aged
Pancreatitis / complications,  diagnosis,  mortality*
Respiratory Insufficiency / complications
Shock, Septic / complications
Tachycardia / complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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