Overview :

Makela et al evaluated risk factors for morbidity and mortality in patients with severe acute pancreatitis. These can help identify a patient who may require more aggressive management. The authors are from the University of Oulu in Finland.

Patient population: 68 adults, with 58 males and 10 females, ranging from 21 to 83 years (mean 58-59)

Risk factors for mortality in ED or ICU:

(1) C-reactive protein (CRP) > 150 in mg/L (normal < 10 mg/L), for ED

(2) computer tomography (CT) index (score of Balthazar et al, index modified by UK working party) = 3, for ICU

Risk factors associated with longer stay in the ICU:

(1) male gender

(2) high C-reactive protein concentration

(3) organ failures (renal, pulmonary)

Balthazar EJ, Feeney PC, van Sonnenberg E. Imaging and intervention in acute pancreatitis. Radiology. 1994; 193: 297-306.

Makela JT, Eila H, et al. Computed tomography severity index and C-reactive protein values predicting mortality in emergency and intensive care units for patients with severe acute pancreatitis. Am J Surg. 2007; 194: 30-34.

UK Working Party on Acute Pancreatitis. UK guidelines for the management of acute pancreatitis. Gut. 2005; 54 (supplement 3): iii1 to iii9.