Outcome of patients with acute, necrotizing pancreatitis requiring drainage-does drainage size matter?

Table 1 Patient characteristics

Patient, n = 80	n/median (%/range)
Demographics
Age	57 (17-79)
Sex, female	26 (32.5)
Days of hospitalisation	51 (3-241)
Required second hospitalisation	5 (6.3)
Aetiology
Biliary	26 (32.5)
Alcoholic	32 (40.0)
Post-ERCP	3 (3.8)
Toxic	1 (1.3)
Hyperlipidemia	1 (1.3)
Hyperparathyroidism	1 (1.3)
Posttraumatic	1 (1.3)
Idiopathic/unknown	15 (18.8)
Ranson score	2 (0-4)
Diagnostic procedures
Ultrasound	74 (92.5)
ERCP	32 (40.0)
CT	80 (100)
Balthazar score	4 (3-4)
CTSI	6 (4-10)
Inflammatory markers
Leucocyte count d 1 of our hospital admission (/nL)	13 (3.5-55.0)
Leucocyte count on day of first drainage placement (/nL)	14.4 (3.5-46.6)
C-reactive protein day 1 (mg/L) of our hospital admission	208 (10-477)
C-reactive protein on day of first drainage placement (mg/L)	191 (20-477)
Therapy
Surgical	20 (25.0)
Minimal-invasive
Number of drainages, range	2 (1-14)
Active necrosectomy	18 (22.5)
Intensive care treatment	65 (81.3)
length of ICU stay, range	22 (2-104)
Required second ICU stays	9 (11.3)
APACHE II, range	18 (1-38)
SAPS II, range	61 (15-94)
Non-invasive positive pressure ventilation	2 (2.5)
Mechanical ventilation	50 (62.5)
Renal replacement therapy	23 (28.8)
Plasma exchange therapy	7 (8.8)
Mortality	27 (33.8)
Cause of Death
Septic multi-organe failure	24 (88.9)
Pulmonary embolism	1 (3.7)
Intracerebral bleeding	1 (3.7)
Due to polytrauma	1 (3.7)

ERCP: Endoscopic Retrograde Cholangiopancreatography; CT: Computed Tomography; CTSI: Computed Tomography Severity Index; ICU: Intensive Care Unit; APACHE: Acute Physiology and Chronic Health Evaluation; SAPS: Simplified Acute Physiology Scale.

Table 2 Cox proportional hazard model for overall mortality using uni- and multivariate analysis

Variable	Mono-HR	P	Multi-HR	P
Age	0.985	0.098	-
Sex	0.926	0.793	-
CTSI	0.933	0.281	0.982	0.819
Apache II Score	0.961	0.016	0.989	0.716
SAPS II Score	0.976	0.002	1.004	0.809
Clinical treatment modalities
Invasive ventilation	0.175	0.000	5.618	0.001
Renal replacement therapy	0.329	0.005	2.347	0.046
Interventional treatment modalities
Number of drainages	0.892	0.077	-
Median drainage size	0.989	0.830	-
Largest drainage size	0.954	0.307	-
Total drainage plane	0.994	0.052	0.993	0.084

Mono-HR: Monovariate hazard ratio; Multi-HR: Multivariate hazard ratio; APACHE: Acute Physiology and Chronic Health Evaluation; SAPS: Simplified Acute Physiology Scale; CTSI: Computed Tomography Severity Index.

Table 3 Outcome parameters of patients after treatment with percutaneous drainage applied 1-12 years after hospital discharge by a telephone investigation

Outcome parameters from 29 patients	n	%
Life quality parameters
Abdominal Pain	5	17.2
Diarrhea	7	24.1
Intolerance of fat	4	13.8
Weight loss	7	24.1
Exocrine pancreatic dysfunction (with substitution of pancreatic enzymes)	7	24.1
Endocrine pancreatic dysfunction	10	34.5
Repeated development of pancreatitis	3	10.3
Further hospitalisations	8	27.6
Surgery after discharge	7	24.1
Death after discharge	4	13.8