Table 5

Clinical outcomes: studies in patients with MSAP or SAP

Author, year; countryStudy design; setting (data period)SIRS (%)SSOF or MSOF (%)TOF or POF (%)Admission to CC (%)IPN (%)Surgery due to PN (%)Pancreatic pseudocysts (%)Other long-term outcomes of surviving patients (%)Mortality (%)
USA studies: MSAP
 Koutroumpakis et al, 2017,19 Koutroumpakis et al, 201420; USAProspective cohort; hospital
2003 to 2014		SIRS on admission: 48%
SIRS at 48 hours: 41%		NRTOF: 100%23%9%NRNRNR0%
 Kwong et al, 201621; USARetrospective cohort; secondary care
November 2010 to December 2013		Day 1/Day 2
Score 1: 23/29%
Score 2: 29/26%
Score 3: 23%
Score 4: 13/6%		26.1%TOF: 26.1%23%NRNRNRNRNR
 Talukdar et al, 201224; USAProspective cohort study; three hospitals
June 2004 and August 2005		NRNRNR15%NRNRNRNR0%
USA studies: SAP
 Bhat et al, 200718; USAProspective cohort; hospital
June 2003 and January 2005		NRSSOF: 31.6% (6/19)
MSOF: 47.4% (9/19)		NRNRPN: 21.1%NRNRNR32%
 Koutroumpakis et al, 2017,19 Koutroumpakis et al, 201420; USAProspective cohort; hospital
2003 to 2014		SIRS on admission: 65%
SIRS at 48 hours: 77%		SSOF: 40%
MSOF: 60%		100%93%IPN: 32%
PN: 68%		NRNRNR21%
 Mutch et al, 201123; USARetrospective cohort; seven hospitals (2008)NRNRNRNRNRNRNRNRNR
 Soran et al, 200022; USARetrospective cohort; secondary care 1992–1996NRNRNRNRNRNRNRNRNR
 Talukdar et al, 201224; USAProspective cohort study; three hospitals
June 2004 and August 2005		NRSSOF: 47%
MSOF: 53%
Renal failure: 80%
Respiratory failure: 67%
Circulatory failure: 13%		POF at presentation: 7%
POF during hospital stay: 93%		80%NRNRNRNR40%
EU-5 studies: MSAP
 Pintado et al, 201636; SpainProspective cohort; 14-bed medical and surgical ICU 2010–2014NRMOF at ICU admission: 0%
MOF during ICU stay: 8.3%		NRNR10%16.7%0%NR0%
EU-5 studies: SAP
 Castoldi et al, 201332; ItalyRetrospective cohort; 35 hospitals (NR)NRNRNRNRNRNRNRRelapse to mild AP cases: 13.7%
Relapse to severe AP: 8.2%:
Recovery time: mean 53.4 (SD 41.1) days
Diabetes: 4.1%		Long-term (follow-up mean 49 (SD 10.7) months: 12.3%
 Cinquepalmi et al, 200633; ItalyRetrospective cohort; hospital 1990–2005NRNRNRNR100% (selection criterion for the study)100% (selection criterion for the study)NRNR22%
 De Rai et al, 201034; ItalyProspective cohort; 56 centres
July 2002 and December 2011		NRNRNRNR4.8%4.8%NRNR19.16%
 Gomercic et al, 201635; FranceProspective cohort; hospital 2010–2012NR

  • Identified the first 48 hours after pain onset: cute respiratory distress syndrome: 12.7%

Acute renal failure: 1.4%
MOF: 4.2%		NR

  • Identified the first 48 hours after pain onset: 69.4%

  • Identified the first 36 hours after pain onset: 60.7%

NRNRNRNRNR
 Gonzelez et al, 201125; UKRetrospective study of prospective data; tertiary referral centre
January 2008 and December 2009		NRNRNRNR40%NRNRNR5%
 Hall et al, 201326; UKRetrospective cohort; tertiary referral centre 2003–2011NRNRNRNRNRNRNRNR17.8%
 Harrison et al, 200727; UKRetrospective cohort; general critical care unitsNREmergency surgery: 10.5%
Elective surgery: 5.3%		NRNRCC unit mortality: 30.6%
Ultimate hospital mortality: 41.9%
Primary reason for admission:
AP: 42.5%
Infective pancreatitis: 48%
Non-surgical: 44.3%
 Heiss et al, 201129; GermanyRetrospective cohort; tertiary referral single-centre 1992–2004NRNRNR81%Necrosis of the pancreatic head: 68%
parts of the pancreas that exhibited areas of necrosis:
0 parts: 9%
one part: 29%
two parts: 23%
All three parts: 40%		Surgical and percutaneous necrosectomy: 25% and 22.5%NRExtrapancreatic complications: 94%Overall: 34%
Among those with multiple organ dysfunction: 89%
Among those with all 3 areas of necrosis: 38%
Among those with the presence of distal fluid collections: 46%
Absence of distal fluid collections: 42%
 Patel, 201528; UKRetrospective cohort; hospital 2007–2010NRNRNRNR37%
 Pintado et al, 201636; SpainProspective cohort; 14-bed medical and surgical ICU 2010–2014NRMOF at ICU admission: 36.4%
MOF during ICU stay: 86.4		POF: 100%NR11.4%NR2.3%NR29.5%
 Rasch et al, 201630; GermanyRetrospective cohort; seven tertiary referral centres and three secondary hospitals 2008–2014NRNRPersistent dysfunction: 21.8%NR72.7%13.6%NRNR13.6%
 Wittau et al, 201031; GermanyRetrospective cohort; tertiary care hospital 1992–1997; 2001–2006NRMOF:
Group 1: 36%
Group 2: 25%		NRNRGroup 1: 40%
Group 2: 69%		NRNRNRGroup 1: 28%
Group 2: 14%

  • ACG criteria required the presence of at least two of the following three factors: (1) abdominal pain characteristic of AP; (2) serum amylase and/or lipase levels three or more times ULN; (3) CT findings characteristic of AP.

  • ACG, American College of Gastroenterology; AP, acute pancreatitis; CC, coronary care; EU-5, European Union-5; ICU, intensive care unit; IPN, infected pancreatic necrosis ; MOF, multiple organ failure; MSAP, moderately severe acute pancreatitis; MSOF, multisystem organ failure; NR, not reported; PN, pancreatic necrosis; POF, partial organ failure; SAP, severe acute pancreatitis; SD, standard deviation; SIRS, systemic inflammatory response syndrome; SSOF, single system organ failure; TOF, total organ failure; UK, United Kingdom; ULN, upper limit of normal; USA, United States of America.