Faculty Collaboration Database

Acute Pancreatitis in the Pediatric Intensive Care Unit. J Pediatr Gastroenterol Nutr 2015 Jul;61(1):108-12

Date

03/10/2015

Pubmed ID

25749464

DOI

10.1097/MPG.0000000000000780

Scopus ID

2-s2.0-84937688226 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

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.

Author List

Goday PS, Wakeham M, Kuhn EM, Collins MM, Werlin SL

Author

Martin K. Wakeham MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Female
Hospitalization
Humans
Intensive Care Units, Pediatric
Length of Stay
Male
Pancreatitis
Patient Discharge
Prognosis
Respiration, Artificial
Retrospective Studies
Severity of Illness Index