PancRea: Risk Factors and Outcomes of Infected Pancreatic Necrosis
PancRea: Risk Factors and Outcomes of Infected Pancreatic Necrosis
Severe acute pancreatitis is a common reason for intensive care unit (ICU) admission and is
 associated with prolonged hospital stays and high morbidity and mortality rates. The Atlanta
 classification differentiates mild, moderate, and severe acute pancreatitis, and each of
 these categories correlates with morbidity and mortality. Mortality remains high, between 10%
 and 39%, in severe and moderately severe acute pancreatitis. After the first week, about 30%
 of patients with necrotizing pancreatitis develop infected pancreatic necrosis (IPN). IPN is
 a risk factor for mortality.The treatment of IPN combines antibiotics with interventions to
 remove the infected intra-abdominal material, preferably using minimally invasive techniques
 such as percutaneous and endoscopic drainage, which have been proven beneficial. In several
 studies biological markers such as procalcitonin and interleukin 8 were effective in
 predicting IPN. However, few clinical risk factors for IPN have been reported. Identifying
 risk factors may help to improve standardized strategies for early diagnosis and treatment,
 and then patients outcome. Our primary objective was to identify risk factors for IPN in
 patients admitted to the ICU for acute pancreatitis. Our secondary objective was to describe
 the management and outcomes of IPN
Using electronic patient data monitoring systems, the investigators reviewed all patients
 with a diagnosis of acute necrotizing pancreatitis admitted to digestive liver disease unity
 or ICUs at the Nantes University Hospital, from January 1, 2012, to december 31, 2015. For
 enrolled patients, general clinical characteristics were collected. Patients were categorized
 into two groups according to the development of an infected pancreatic necrosis (highly
 suspected or proven), and the differences of these characteristics between two groups were
 evaluated. Potential risk factors were collected and studied by using multiple logistic
 regression analysis.
Inclusion Criteria:

 -  Adult patients (age >18 years) with acute necrotizing pancreatitis admitted in an ICU
 between January 2012 and December 2015 for moderately severe or severe acute
 pancreatitis were included.

 -  Organ failure that resolves within 48 h (transient organ failure) and/or local or
 systemic complications without persistent organ failure or persistent organ failure
 (>48 h)

 Exclusion Criteria:

 -  mild acute pancreatitis, defined as no organ failure or local complication (No
 necrosis or peri-pancreatic collection)