The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study

Xun Jiang; Ji-Yu Shi; Xia-Yu Wang; Yong Hu; Yun-Feng Cui

doi:10.1186/s40779-020-00265-5

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The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study

RESEARCH | Updated：2023-02-28

- The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study
- The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study
- 解放军医学杂志（英文版） 2021年8卷第1期页码：37-47
- Affiliations：
  
  1.Tianjin Medical University, Tianjin 300041, China
  2.Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, 122 Sanwei Road, Nankai district, Tianjin 300110, China
- Author bio：
  
  * NKYYCYF@163.com
- Funds：
- DOI：10.1186/s40779-020-00265-5
  中图分类号：
- 纸质出版：2021-03
- Accepted：
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The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study[J]. 解放军医学杂志（英文版）, 2021,8(1):37-47.

Jiang et al.: The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study. Mil Med Res, 2020, 7: 38.
The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study[J]. 解放军医学杂志（英文版）, 2021,8(1):37-47. DOI： 10.1186/s40779-020-00265-5.

Jiang et al.: The impacts of infectious complications on outcomes in acute pancreatitis: a retrospective study. Mil Med Res, 2020, 7: 38. DOI： 10.1186/s40779-020-00265-5.

摘要

Abstract

Background:

The occurrence of infectious complications characterizes the more severe forms of acute pancreatitis (AP) and is associated with high mortality. We investigated the effects of infection at different sites in patients with AP

including those with necrotizing pancreatitis (NP).

Methods:

We conducted a retrospective analysis of 285 patients who met the inclusion criteria for AP and were admitted to Tianjin Nankai Hospital between January 2016 and September 2019. According to the source of the culture positivity during hospitalization

patients were divided into four groups: sterile group (

=148)

pancreatic infection group (

=65)

extrapancreatic infection group (

=22) and combined infection group (

=50). The source of infection

microbiology

biochemical parameters and prognostic indicators were analyzed.

Results:

In terms of baseline characteristics

the four groups were similar in age

sex

aetiology

previous pancreatitis and diabetes. Compared with the severity of the disease in the other groups

the APACHE II scores (9.91±4.65

9.46±5.05

respectively) and organ failure rate (40.9% and 50%

respectively)were higher in the extrapancreatic infection group and the combined infection group (

0.05). The frequency of surgical intervention and hospitalization time in patients with NP complicated with extrapancreatic infection was greatly increased (

0.05). Regarding the primary outcome

patients in the combined infection group had longer hospital stays (68.28±51.80

. 55.58±36.24

0.05) and higher mortality (24.0%

. 9.2%

0.05) than patients in the pancreatic infection group. In addition

patients in the extrapancreatic infection group also showed high intensive care utilization (59.1%) and mortality rates (18.2%). Among the 137 AP patients with infection complications

89 patients exhibited multidrug-resistant (MDR) microorganisms

and the mortality rate of patients with MDR bacterial infection was higher than that of patients with non-MDR bacterial infection (24.7%

. 3.6%

=0.001).

Conclusions:

Clinicians should be aware that extrapancreatic infection (EPI) significantly aggravates the main outcome in pancreatic infection patients. Infection with MDR bacteria is also associated with AP mortality.

关键词

Keywords

references

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