Morality due to Open Pancreatic Necrosectomy

Abstract

Introduction: Open pancreatic necrosectomy is a surgical technique used in necrosis infection.

Objective: To identify the factors related to prognosis in patients operated on under the diagnosis of acute necrotizing pancreatitis.

Methods: A prospective cohort study was carried out in patients operated on under the diagnosis of acute necrotizing pancreatitis, in the intensive care unit of Carlos Manuel de Céspedes General University Hospital of Bayamo, Granma, Cuba, in the period 2018-2020. Sixty-one patients with this diagnosis were included. Demographic, clinical, humoral and surgical variables were studied. A bivariate and multivariate strategy was used.

Results: In the bivariate analysis, the influence of age (relative risk [RR]=3.34; 95% confidence interval [CI]: 0.17-0.68) and tomographic severity index (RR=1.85; 95% CI: 0.66-2.37), as well as multiple organ dysfunction (RR=5.06; 95% CI: 1.08-2.15), early surgery (RR=2.78; 95% CI: 1.00-3.34) and necrosis infection (RR=6.60; 95% CI: 1.01-5.23) were highlighted. In the multivariate logistic regression model, multiple organ dysfunction (RR=6.58; 95% CI: 2.40-18.08) and infection of necrosis (RR=14.20; 95% CI: 5.93-34.01) were included as independent variables associated with prognosis.

Conclusions: Mortality analysis evidenced that the factors that showed significant association were multiple organ dysfunction and necrosis infection.