Document Detail


Prediction of early death in severe acute pancreatitis.
MedLine Citation:
PMID:  18306989     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In severe acute pancreatitis (SAP), it is clinically important at the time of admission to predict the likelihood of early death. This investigation aimed to clarify the factors predicting early death in SAP. METHODS: Early death was defined as death within 10 days after disease onset. Prediction factors for early death were evaluated from data obtained on admission from 93 patients with SAP, and the characteristics of patients who died early were analyzed. RESULTS: Between the early-death and early-survival groups, significant factors were base excess (BE), serum creatinine (Cr), blood sugar, serum glutamate oxaloacetic transaminase, and serum calcium. Multivariate analysis revealed that BE was an independent prediction factor for early death. The early-death rate in patients with BE < -5.5 mEq/l and Cr >or= 3.0 mg/dl was 31% and 36%, respectively. The combination of BE and Cr raised the positive predictive value to 50%, and was equally able to predict early death as the Japanese Severity Score (JSS), which was the most useful of the three conventional scoring systems used. All early-death patients had pancreatic necrosis, and their JSS was >or= 15 (stage 4). Characteristically, early-death patients had lactate dehydrogenase (LDH)>1300 IU/l, or they had serious preexisting comorbidities. CONCLUSIONS: As a single parameter, BE was most useful for predicting early death. The combination of BE and Cr could predict early death as well as the JSS. An extreme rise of LDH and serious preexisting comorbidity may also be risk factors for early death.
Authors:
Makoto Shinzeki; Takashi Ueda; Yoshifumi Takeyama; Takeo Yasuda; Naoki Matsumura; Hidehiro Sawa; Takahiro Nakajima; Ippei Matsumoto; Tsunenori Fujita; Tetsuo Ajiki; Yasuhiro Fujino; Yoshikazu Kuroda
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-29
Journal Detail:
Title:  Journal of gastroenterology     Volume:  43     ISSN:  0944-1174     ISO Abbreviation:  J. Gastroenterol.     Publication Date:  2008  
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  152-8     Citation Subset:  IM    
Affiliation:
Department of Gastroenterological Surgery, Kobe University Graduate School of Medical Sciences, 7-5-2 Kusunoki, Chuo-ku, Kobe, 650-0017 Japan.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aspartate Aminotransferases / blood
Creatinine / blood
Female
Humans
L-Lactate Dehydrogenase / blood
Male
Middle Aged
Multivariate Analysis
Pancreatitis / etiology,  mortality*
Pancreatitis, Alcoholic / mortality
Predictive Value of Tests
Severity of Illness Index
Survival Analysis
Chemical
Reg. No./Substance:
60-27-5/Creatinine; EC 1.1.1.27/L-Lactate Dehydrogenase; EC 2.6.1.1/Aspartate Aminotransferases

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


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