Original article—liver, pancreas, and biliary tractEarly Systemic Inflammatory Response Syndrome Is Associated With Severe Acute Pancreatitis
Section snippets
Methods
The demographic, clinical, laboratory, and radiologic data for all patients directly admitted to our institution with a diagnosis of acute pancreatitis between June 2005 and December 2007 were collected for this study. All patients transferred from outside institutions were excluded. Data for all patients were prospectively collected for 7 days or until discharge if fewer than 7 days. This study was approved by the Partners Institutional Review Board.
Acute pancreatitis was defined as 2 or more
Results
Table 3 depicts the baseline clinical characteristics of 252 consecutive patients admitted directly to our institution over a 2 and a half year period. A majority of patients (73%) were experiencing their first episode of acute pancreatitis.
Table 4 demonstrates the distribution of markers of severity among the 252 patients. There were 38 (15%) patients with organ failure during the first 7 days of hospitalization: 25 (10%) with transient and 13 (5%) with persistent organ failure. Of the 13
Discussion
SIRS is the clinical manifestation of the inflammatory process that can occur after a variety of infectious and noninfectious insults. SIRS has been studied in several noninfectious diseases, including trauma,13 cirrhosis,14 and subarachnoid hemorrhage.15 However, to date, there has been no prospective clinical study that has examined the role of SIRS in assessing severity in acute pancreatitis.
In our study, 62% of all patients had SIRS on the first day of hospitalization, and 74% during the
Acknowledgments
The preliminary data for this study was presented as an oral presentation at the American Society for Gastrointestinal Endoscopy 11th Annual Young Investigators Conference, San Diego, April 21, 2007 and as a Poster of Distinction in the AGA Clinical Acute Pancreatitis Session, Digestive Diseases Week, Washington, DC, May 22, 2007.
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Conflict of interest The authors disclose no conflicts.
Funding This study was supported by a clinical research grant from the National Pancreas Foundation to PAB (Principle Investigator) and V.K.S (Co-Investigator).