Objective: To investigate clinical characteristics of fulminant pancreatitis (FP) died at early and late stage, analyze the difference in death causes of FP at these two stage.
Methods: Ninety-two (92) patients with FP were admitted in our center from January 2000 to June 2010, and 55 patients of them died of FP. These dead FP patients were divided into two groups according to the death time: within 7 d (early death group) or after 7 d (late death group). The 24 h Acute Physiology and Chronic Heath Evaluation II (APACHE II) score, the occurrence of complications were compared between these two groups.
Results: The mortality of FP was 59.8% (55/92), in which 20.6% (19 cases) died within 3 d and 29.3% (27 cases) died after 14 d. Compared with the late death group, the early death group showed higher 24 h APACHE II score and serum triglyceride level (P < 0.05), and also had higher occurring time of renal failure, shock, hepatic failure, encephalopathy, gastrointestinal hemorrhage and infection (P < 0.05). However, the incidences of encephalopathy, gastrointestinal hemorrhage and pancreatic necrosis infection in the late death group were higher than those in the early group (P < 0.05). In addition, the major pathogenesis of infection was Gram-negative bacterium.
Conclusion: The most important and common cause of death for the patients with FP is multiple organ dysfunction syndrome, which usually was the consequence of systemic inflammation response syndrome in the early stage, and the severe infection in the later stage, respectively.