RELATIONSHIP OF NECROSIS TO ORGAN FAILURE IN SEVERE ACUTE-PANCREATITIS

Background & Aims: Pancreatic necrosis and organ failure are principal determinants of severity in acute pancreatitis. The purpose of this s tudy was to determine the relationship of necrosis to organ failure in severe acute pancreatitis, Methods: Patients with necrotizing pancrea titis from May 1992 to January 1996 were retrospectively studied. Panc reatic necrosis was identified by characteristic findings on dynamic c ontrast-enhanced computerized tomography scan and infected necrosis by computerized tomography-guided percutaneous aspiration, Organ dysfunc tion was defined in accordance with the Atlanta symposium. Results: Or gan failure was present in only 26 of 51 patients (51%). There was no difference in the prevalence of organ failure in infected necrosis com pared with sterile necrosis (approximately 50% in both groups), Patien ts with increased amounts of necrosis did not have an increased preval ence of organ failure or infected necrosis compared with those with le sser amounts of necrosis, Patients with organ failure had an increased morbidity and mortality compared with those without organ failure. Co nclusions: Organ failure occurred in only one half of patients with ne crotizing pancreatitis, Because organ failure increases the severity o f illness, studies of patients with necrotizing pancreatitis must stra tify for organ failure to facilitate interpretation of results.