New-onset persistent organ failure predicts adverse outcomes in patients with severe acute pancreatitis

Table 1 Comparison of baseline and clinical characteristics among new-onset multi-organ failure, new-onset single organ failure, and organ failure groups, n (%)

Characteristics	NOOF (n = 38)		OF (n = 113)	P value1	P value2
	NOMOF (n = 21)	NOSOF (n = 17)
Age, years, median (IQR)	42 (35, 67)	48 (35, 59)	48 (37, 59)	0.663	0.791
Male	10 (47.6)	11 (64.7)	55 (48.7)	0.482	0.292
BMI, mean ± SD	25.6 ± 2.8	26.5 ± 2.8	26.4 ± 3.1	0.466	0.332
Etiology				0.186	0.652
Biliary	10 (47.6)	7 (41.2)	33 (29.2)
Hypertriglyceridemia	7 (33.3)	8 (47.1)	52 (46.0)
Others	4 (19.0)	2 (11.8)	28 (24.8)
Severity
APACHE II score, median (IQR)	14 (11, 19)	16 (13, 20)	11 (8, 14)	< 0.001a	0.263
BISAP score, median (IQR)	3 (3, 4)	3 (2, 3)	2 (2, 3)	0.001a	0.117
CTSI score, median (IQR)	8 (8, 10)	8 (6, 10)	4 (4, 6)	< 0.001a	0.348
MOF on admission	12 (57.1)	9 (52.9)	19 (16.8)	< 0.001a	0.796
OF duration > 2 weeks	19 (90.5)	10 (58.8)	17 (15.0)	< 0.001a	0.058
IPN	19 (90.5)	14 (82.4)	19 (16.8)	< 0.001a	0.800
Major complications	15 (71.4)	11 (64.7)	13 (11.5)	< 0.001a	0.658
Interventions
Step-up approach	14 (66.7)	11 (64.7)	20 (17.7)	< 0.001a	0.899
OPN	5 (23.8)	3 (17.6)	0 (0)	< 0.001a	0.950

^aP < 0.05.

¹Group new-onset organ failure vs organ failure.

²Group new-onset multi-organ failure vs new-onset single organ failure.

NOOF: New-onset organ failure; OF: Organ failure; NOMOF: New-onset multi-organ failure; NOSOF: New-onset single organ failure; IQR: Interquartile range; BMI: Body mass index; APACHE: Acute physiology and chronic health assessment; BISAP: Bedside Index of Severity in Acute Pancreatitis; CTSI: Computed tomography severity index; MOF: Multiple organ failure; IPN: Infected pancreatic necrosis; OPN: Open pancreatic necrosectomy.

Table 2 Comparison of clinical outcomes among new-onset multi-organ failure, new-onset single organ failure, and organ failure groups, n (%)

Characteristics	NOOF (n = 38)		OF (n = 113)	P value1	P value2
	NOMOF (n = 21)	NOSOF (n = 17)
ICU admission	21 (100.0)	17 (100.0)	88 (77.9)	0.002a	-
ICU LOS, median days (IQR)	45 (24, 58)	30 (13, 51)	8 (3, 13)	< 0.001a	0.347
Hospital LOS, median days (IQR)	50 (35, 62)	93 (44, 117)	29 (21, 40)	< 0.001a	0.086
Hospital care costs, thousand CNY, median (IQR)	538 (309, 690)	553 (273, 772)	83 (55, 144)	< 0.001a	0.941
OF duration, median days (IQR)	37 (21, 47)	20 (12, 30)	7 (3, 11)	< 0.001a	0.015a
MV duration, median days (IQR)	7 (2, 21)	0 (0, 6)	0 (0, 0)	< 0.001a	0.016a
Vasopressors duration, median days (IQR)	6 (3, 8)	1 (0, 9)	0 (0, 0)	< 0.001a	0.028a
RRT duration, median days (IQR)	12 (3, 18)	1 (0, 10)	0 (0, 0)	< 0.001a	0.039a
In-hospital mortality	12 (57.1)	1 (5.9)	2 (1.8)	< 0.001a	0.001a
90-day mortality	17 (81.0)	3 (17.6)	3 (2.7)	< 0.001a	< 0.01a

^aP < 0.05.

¹Group new-onset organ failure vs organ failure.

²Group new-onset multi-organ failure vs new-onset single organ failure.

NOOF: New-onset organ failure; OF: Organ failure; NOMOF: New-onset multi-organ failure; NOSOF: New-onset single organ failure; ICU: Intensive care unit; LOS: Length of stay; IQR: Interquartile range; CNY: Chinese Yuan; MV: Mechanical ventilation; RRT: Renal replacement therapy.

Table 3 Predictors of in-hospital mortality among patients with severe acute pancreatitis, n (%)

Variables	Died (n = 15)	Survived (n = 136)	Univariable analysis		Multivariable analysis
			OR (95%CI)	P value	OR (95%CI)	P value
Age, median (IQR)	47 (39, 61)	47 (35, 61)	1.1 (0.9-1.1)	0.497
Male	8 (53.3)	68 (50)	1.1 (0.4-3.3)	0.807
BISAP score, median (IQR)	3 (3, 4)	3 (2, 3)	3.3 (1.6-6.8)	0.002a	4.0 (1.3-12.0)	0.013a
CTSI score, median (IQR)	8 (8, 10)	4 (4, 6)	1.7 (1.3-2.2)	< 0.001a
IPN	12 (80.0)	40 (29.4)	9.6 (2.6-35.9)	0.001a
OPN	4 (26.7)	4 (2.9)	12.0 (2.6-54.7)	0.001a
MC	13 (86.7)	26 (19.1)	27.5 (5.8-129.4)	< 0.001a	13.2 (2.1-83.5)	0.006a
MOF on admission	10 (66.7)	30 (22.1)	7.1 (2.2-22.3)	0.001a
OF duration > 2 weeks	12 (80.0)	34 (25)	12.0 (3.2-45.1)	< 0.001a
NOOF	13 (86.7)	25 (18.4)	28.9 (6.1-136.1)	< 0.001a	7.5 (1.3-42.6)	0.024a

^aP < 0.05.

OR: Odds ratio; CI: Confidence interval; IQR: Interquartile range; BISAP: Bedside Index of Severity in Acute Pancreatitis; CTSI: Computed tomography severity index; IPN: Infected pancreatic necrosis; OPN: Open pancreatic necrosectomy; MC: Major complications; MOF: Multiple organ failure; OF: Organ failure; NOOF: New-onset organ failure.