Acute lung injury in patients with severe acute pancreatitis.

OBJECTIVE

Severe acute pancreatitis can result in acute lung injury. This study aims to investigate the clinical characteristics and possible prediction index of acute lung injury in severe acute pancreatitis.

METHODS

We retrospectively evaluated 184 patients with severe acute pancreatitis admitted between April 2007 and July 2010. There were 51 patients who developed acute lung injury with a rate of 27.7% (51/184). Clinical data of the acute lung injury and non-acute lung injury patients were compared, and the characteristics of acute lung injury were also analyzed. Meanwhile, we validated a few possible prediction indexes to identify the patients at high risk for acute lung injury at the time of hospital admission.

RESULTS

The severity index, hospital day, and the incidence of infectious complications were significantly higher in the acute lung injury patients than in the nonacute lung injury patients (p<0.05). The differences between the non-acute lung injury and acute lung injury groups in mortality (3% vs. 11.8%, p<0.05), operation (5.3% vs. 15.7%, p<0.05), and incidence of renal failure (15.8% vs. 33.3%, p<0.05), cardiovascular failure (3.8% vs. 15.7%, p<0.05), and pancreatic cyst (18% vs. 37.3%, p<0.05) were statistically significant. The patients with higher level of severity index score, acidosis, tachypnea, smoking history, and obesity were prone to develop acute lung injury. conclusion: Acute lung injury occurrence in patients with severe acute pancreatitis varies according to predisposing conditions and independently carries poor prognosis.