[Clinical characteristics and prognostic factors of fulminate pancreatitis]

To study the clinical characteristics of fulminate pancreatitis (FP) and analysis the factors related to prognosis of FP.

Data of 203 patients with severe acute pancreatitis (SAP) admitted to our hospital within 72 h after onset of symptoms from January 2000 to December 2002 were reviewed. FP was defined as presence of organ dysfunction within 72 h after onset of symptoms. 78 patients had FP, 125 patients without organ dysfunction within 72 h after onset of symptoms had common severe acute pancreatitis (CSAP). The clinical characteristics, incidence of organ dysfunction during hospitalization and prognosis between FP and CSAP were compared, then the factors related to prognosis of FP were analysed.

The incidences of T >/= 38.5 degrees C, hypoxemia, shock, white cell count >/= 16 x 10(9)/L, serum calcium < 2.0 mmol/L and multiple organ dysfunction syndrome (MODS) in FP were higher than those in CSAP (71.8% vs 39.2%, 83.3% vs 30.4%, 41.0% vs 12.0%, 64.1% vs 30.4%, 68.0% vs 44.8%, 73.1% vs 11.2%, P < 0.05). Impairment degree of pancreas (Balthazar CT severity index) in FP was more serious than that in CSAP (5.78 +/- 0.83 vs 3.12 +/- 0.57, P < 0.05). FP had a higher mortality than CSAP (44.9% vs 8.8%, P < 0.05). In multiple logistic regression analysis, the main predisposing factors to FP were hypoxemia, MODS and Balthazar CT severity index.

FP is characterised by severe systemic inflammatory response, severe pathological changes of pancreas, high incidence of MODS and high mortality. The main predisposing factors to FP were hypoxemia, MODS and Balthazar CT severity index.