Facteurs prédictifs de l’infection de nécrose dans les pancréatites aiguës : une étude observationnelle multicentrique

Abstract : Background: infected necrosis represents a severe complication of acute necrotizing pancreatitis, which may require interventional treatments according to a step-up approach in reference centers. The aims of our study were to identify early predictive factors of infected necrosis and to evaluate the Atlanta 2012 classification, the APACHE 2 score and the SOFA score for predicting this outcome. Methods: we conducted a retrospective study including all patients admitted in three intensive care units for acute necrotizing pancreatitis between 2007 and 2015. Results: a total of 159 patients were included, 97 patients presented sterile necrosis while 62 suffered from infected pancreatic necrosis. The need of mechanical ventilation at day 2 after ICU admission, previous abdominal surgery and platelet count at ICU admission were found as independent factors associated with infected pancreatic necrosis. Severity of pancreatitis according to the Atlanta 2012 classification, the Acute Physiology and Chronic Health Evaluation (APACHE) II and the Sequential Organ Failure Assessment (SOFA) scores at admission and 48h did not predict the occurrence of infected pancreatic necrosis. Conclusion: the need of mechanical ventilation at day 2, previous abdominal surgery and high platelets at admission are independent factors of infected necrosis and their combination might predict the occurrence of infected necrosis in acute pancreatitis. These infected pancreatic necrosis risk factors might help to address early patients to referral pancreatitis centers.
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Master Thesis
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Hélène Jacob. Facteurs prédictifs de l’infection de nécrose dans les pancréatites aiguës : une étude observationnelle multicentrique. Médecine humaine et pathologie. 2018. ⟨dumas-02074259⟩

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