Outcome of Patients With Alcoholic Pancreatitis Admitted to Intensive Care Unit: A Single Center Experience
Background - While there is data on course and outcome of patients admitted with biliary pancreatitis, no study has assessed the outcome of patients admitted with alcoholic pancreatitis to intensive care units (ICU). Aims - To assess the outcome of alcoholic pancreatitis patients admitted to ICU. Methods - Prospective observational study of 37 consecutive patients with first episode of acute alcoholic pancreatitis admitted to ICU over a two year period. Data on patient characteristics and that required calculation of severity scores were collected. Patients were followed up to 30-days of discharge from ICU with 30-day mortality being the primary outcome measure. Results - Complications developed in 26 (70.3%) and necrosis in 23 (62.2%) patients. Six patients (16.2%) underwent pancreatic necrosectomy. ICU and 30-day mortality was 21.6% and 29.7%, respectively. On multivariate regression analysis, development of renal failure (adjusted odds ratio of 57.33, 95% CI: 2.77-1188.02, p=0.009) was significantly associated with 30-day mortality. Though all severity scores had comparable efficacy, SOFA score performed better with area under curve of 0.91 and 0.92 in predicting severity and 30-day mortality, respectively. Conclusions - Patients admitted to ICU with alcoholic pancreatitis may represent a distinct patient population with a high incidence of pancreatic necrosis. Development of renal failure is a vital prognosticator of mortality and SOFA score has good accuracy in predicting severity and mortality.