POSTBURN PANCREATITIS

Objective The authors examined the prevalence and complications of pan creatitis in severely burned patients. Factors predictive for the deve lopment of pancreatitis after burns are considered. Summary Background Data Pancreatitis has been documented at necropsy after burns; howeve r, it is not clinically recognized as a common complication of burn in jury. Recent improvements in survival rates could yield previously unr ecognized complications, such as pancreatitis, particularly in those p atients who previously would have not survived. The hypothesis is that pancreatitis is a frequent complication after major burn injury and c auses significant morbidity for patients with large burns. Methods Thi s retrospective review of adult patients with large burns examines pos tburn pancreatitis using stepwise logistic regression analysis. Result s Forty-nine of 121 (40%) patients developed hyperamylasemia or hyperl ipasemia well after the admission period (23 +/- 3 days), and all enzy me abnormalities were temporally associated with emerging infections. Most of these patients (40/49, 82%) had symptoms of pancreatitis. Thre e patients (6%) had pancreatic pseudocysts or abscesses. Inhalation in jury (p = 0.0001), associated trauma (p = 0.0311), and escharotomy (p = 0.0415) were risk factors for pancreatitis. Using Fischer's exact te st, patients with pancreatitis had increased mortality and length of s tay. Patients with high enzyme elevations and greater than or equal to 50% body surface area burned were at severe risk of pancreatic pseudo cyst or abscess development (43%; 90% confidence interval of 23-77%). Conclusions Pancreatitis is a frequent complication after large burn i njuries. Patients at high risk for pancreatitis complications should r eceive surveillance examinations during their acute hospitalization.