Acute Pancreatitis in the Pediatric Intensive Care Unit

作者：Goday Praveen S^*; Wakeham Martin; Kuhn Evelyn M; Collins Maureen M; Werlin Steven L

来源：Journal of Pediatric Gastroenterology and Nutrition, 2015, 61(1): 108-112.

DOI：10.1097/MPG.0000000000000780

• children
• outcomes
• severe acute pancreatitis

Aim:The aim of this study is to describe the demographics and outcomes of children with a discharge diagnosis of acute pancreatitis (AP) from the pediatric intensive care unit (PICU).Methods:Data for this retrospective cohort study were obtained from a multisite, clinical PICU database. PICU discharges with a primary or secondary diagnosis of AP (SAP) between 2009 and 2013 from 113 centers were reviewed. We also obtained the Pediatric Index of Mortality 2 Risk of Mortality (PIM2ROM), an indicator of the severity of illness.Results:Of 360,162 PICU discharges, 2026 with a diagnosis of AP were analyzed further (0.56%)331 had a primary diagnosis of AP, whereas 1695 had a SAP. Among children with primary AP, median PIM2ROM was 1.0% (interquartile range [IQR] 0.8%-1.4%). Fifty-five children with primary AP (16.6%) required mechanical ventilation (MV) for a median of 3.8 days (IQR 1.0-9.3). The length of stay (LOS) in PICU was a median of 2.95 days (IQR 1.53-5.90). Only 1 patient died (mortality 0.3%). Among children with secondary AP, median PIM2ROM was 1.1% (IQR 0.8%-4.0%). A total of 711 children (42.0%) with secondary AP required MV for a median of 5.8 days (IQR 1.8-14.0). PICU LOS was a median of 4.43 days (IQR 1.84-11.22). There were 115 deaths in this group (mortality 6.8%). Median PIM2ROM, PICU LOS, mortality (all P<0.001), and length of MV (P=0.035) were significantly greater in children with secondary AP than with primary AP.Conclusions:Unlike in adult series, children with AP rarely die. Patients with secondary AP experience more morbidity and mortality than patients with primary AP.

• 出版日期2015-7