Acute Pancreatitis in the Pediatric Intensive Care Unit. (July 2015)

• Record Type: Journal Article
• Authors: Goday, Praveen S.; Wakeham, Martin; Kuhn, Evelyn M.; Collins, Maureen M.; Werlin, Steven L.
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 61(2015)Supplement 1
• Publication Date: 2015-07
• Subjects: children -- outcomes -- severe acute pancreatitis; Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000000780
• Languages: English
• ISSNs: 0277-2116

Abstract

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.