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Related Experiment Videos

Sepsis indicators in acute pancreatitis.

S Block1, M Büchler, R Bittner

  • 1Department of General Surgery, University of Ulm, F.R.G.

Pancreas
|January 1, 1987
PubMed
Summary

Infected necrotizing pancreatitis (NP) is often indicated by fever and specific lab values like low base excess and hematocrit. A combination of these factors can predict infection risk in NP patients before surgery.

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Area of Science:

  • Gastroenterology
  • Surgical Critical Care
  • Infectious Diseases

Background:

  • Necrotizing pancreatitis (NP) is a severe condition with significant morbidity and mortality.
  • Bacterial infection of necrotic tissue complicates NP in a substantial proportion of patients.
  • Early identification of infected NP is crucial for timely intervention and improved outcomes.

Purpose of the Study:

  • To identify clinical and laboratory features distinguishing infected from sterile necrotizing pancreatitis.
  • To evaluate the predictive value of specific parameters for bacterial infection in NP.
  • To develop a predictive model for infection in NP patients undergoing surgery.

Main Methods:

  • Retrospective analysis of clinical and laboratory data from 161 patients with NP.

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  • Parameters recorded within 48 hours of admission and 48 hours prior to surgery.
  • Univariate and multivariate logistic regression analyses were employed.

    • Main Results:

    • Elevated rectal temperature (>38.5°C) was a significant indicator of infection post-admission.
    • Pre-operative findings significantly associated with infection included fever, base excess (< -4 mmol/L), hematocrit (<35%), and low paO2 (<60 mm Hg).
    • A combination of fever, low base excess, and low hematocrit predicted infection with 83% probability.

    Conclusions:

    • Fever, base excess, and hematocrit are key indicators for predicting bacterial infection in NP.
    • The identified combination of factors offers a valuable tool for risk stratification in NP patients.
    • Further research may refine diagnostic criteria and treatment strategies for infected NP.