Extra-pancreatic complications, especially hemodialysis predict mortality and length of stay, in ICU patients admitted with acute pancreatitis

Darshan Kothari, Maarten R. Struyvenberg, Michael C. Perillo, Ghideon Ezaz, Steven D. Freedman, Sunil G. Sheth

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background and aims: Patients in the intensive care unit (ICU) with acute pancreatitis (AP) are at risk for extra-pancreatic complications given their severe illness and prolonged length of stay. We sought to determine the rate of extra-pancreatic complications and its effect on length of stay (LOS) and mortality in ICU patients with AP. Methods: We performed a retrospective cohort study of ICU patients admitted to a tertiary-care center with a diagnosis of AP. A total of 287 ICU patients had a discharge diagnosis of AP, of which 163 met inclusion criteria. We calculated incidence rates of extra-pancreatic complications and performed a univariate and multi-variable analysis to determine predictors of LOS and mortality. Results: There were a total of 158 extra-pancreatic complications (0.97 extra-pancreatic complications per patient). Ninety-five patients had at least one extra-pancreatic complication, whereas 68 patients had no extra-pancreatic complications. Patients with extra-pancreatic complications had a significantly longer LOS (14.7 vs 8.8 days, p < 0.01) when controlling for local pancreatic complications. Patients with non-infectious extra-pancreatic complications had a higher rate of mortality (24.0% vs 16.2%, p ¼ 0.04). Patients requiring dialysis was an independent predictor for LOS and mortality (incidence risk ratio [IRR] 1.73, 95% confidence interval [CI]: 1.263–2.378 and IRR 1.50, 95% CI 1.623–6.843, p < 0.01) on multi-variable analysis. Coronary events were also a predictor for mortality (p ¼ 0.05). Other extra-pancreatic complications were not significant. Conclusions: Extra-pancreatic complications occur frequently in ICU patients with AP and impact LOS. Patients with noninfectious extra-pancreatic complications have a higher mortality rate. After controlling for local pancreatic complications, patients requiring dialysis remained an independent predictor for LOS and mortality.

Original languageEnglish
Pages (from-to)202-209
Number of pages8
JournalGastroenterology Report
Issue number3
StatePublished - 1 Aug 2018
Externally publishedYes


  • Extra-pancreatic complications
  • In-hospital mortality
  • Infections
  • Intensive care unit
  • Length of stay
  • Severe acute pancreatitis


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