Clinical outcomes of isolated renal failure compared to other forms of organ failure in patients with severe acute pancreatitis

Table 1 Characteristics among patients with isolated organ failure, multiple organ failure, and no persistent organ failure

	IOF	MOF	P value	No OF	P value
	n = 43	n = 68		n = 389
Mean age ± SD	50.7 (18.5)	56.4 (15.4)	0.08	50.5 ± 18.9	0.97
Male	29 (67.4)	46 (67.6)	0.98	178 (45.8)	0.007
Caucasian	39 (90.7)	61 (89.7)	0.87	344 (88.4)	0.66
Median BMI (IQR)	28.8 (25.7-32.9)	32.2 (28.7-36.4)	0.009	27.5 (24.2-32.9)	0.27
Transfers	35 (81.4)	61 (89.7)	0.21	168 (43.2)	< 0.001
First episode of AP	35 (81.4)	58 (85.3)	0.59	233 (59.9)	0.006
Etiology
Biliary	17 (39.5)	35 (51.5)	0.33	144 (37)	0.03
Alcoholic	12 (27.9)	8 (11.8)		51 (13.1)
Idiopathic	4 (9.3)	9 (13.2)		77 (19.8)
Hypertriglyceridemia	4 (9.3)	9 (13.2)		26 (6.7)
Post-ERCP	2 (4.7)	3 (4.4)		63 (16.2)
Other	4 (9.3)	4 (5.9)		28 (7.2)
Comorbidities
Pre-existing heart failure	0	2 (2.9)	0.26	9 (2.3)	0.31
Pre-existing renal failure	1 (2.3)	4 (5.9)	0.38	8 (2.1)	0.9
Pre-existing respiratory disorder	2 (4.7)	1 (1.5)	0.31	16 (4.1)	0.87

Values presented as mean ± SD or n (%). P values: 1^st column reflects comparison of IOF to MOF, and 2^nd column reflects comparison of IOF to no OF. IOF: Isolated organ failure; MOF: Multiple organ failure; OF: Organ failure; AP: Acute pancreatitis; BMI: Body mass index; IQR: Interquartile range; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 2 Severity predictors, imaging findings, and clinical outcomes among acute pancreatitis patients with isolated organ failure, multi-organ failure, and no persistent organ failure n (%)

	IOF	MOF	P value	No OF	P value
	n = 43	n = 68		n = 389
SIRS score on admission ≥ 2	23 (53.5)	45 (66.2)	0.18	107 (27.5)	< 0.001
SIRS score at 48 h of admission ≥ 2	26 (60.5)	52 (76.5)	0.07	84 (21.6)	< 0.001
Mean IVF the first 24 h in liters (SD)	4.38 (1.98)	5.04 (1.79)	0.41	3.79 (1.5)	0.23
ICU admission	36 (83.7)	68 (100)	0.001	50 (12.9)	< 0.001
Median ICU LOS in days (IQR)	6 (2-14.4)	18.5 (10-35)	< 0.001	0	< 0.001
Need for nutritional support	38 (88.4)	58 (85.3)	0.64	80 (20.6)	< 0.001
Pancreatic necrosis1	28/39 (71.8)	45/54 (83.3)	0.18	80/251 (31.9)	< 0.001
Infected necrosis1	5/39 (12.8)	21/54 (38.9)	0.006	11/164 (6.7)	0.2
Need for drainage or debridement	13 (30.2)	38 (55.9)	0.008	31 (8)	< 0.001
Extra-pancreatic infections	8 (18.6)	30 (44.1)	0.006	27 (6.9)	0.008
Median LOS in days (IQR)	20 (16-32)	37 (25-53)	< 0.001	6 (4-9)	< 0.001
Mortality	0	22 (32.4)	< 0.001	0

¹Denominators reflect number of patients with available contrast-enhanced computed tomography scan. P values: 1^st column reflects comparison of IOF to MOF, and 2^nd column reflects comparison of IOF to OF. AP: Acute pancreatitis; IOF: Isolated organ failure; MOF: Multi-organ failure; OF: Organ failure; SIRS: Systemic inflammatory response syndrome; IVF: Intravenous fluids; ICU: Intensive care unit; LOS: Length of stay; IQR: Interquartile range.

Table 3 Demographics and clinical outcomes in severe acute pancreatitis patients with isolated renal failure and isolated respiratory failure n (%)

	Isolated renal failure	Isolated respiratory failure	P value
	n = 17	n = 25
Male	13 (76.5)	16 (64)	0.39
Mean ± SD	56.1 (18.2)	47.1 (18.6)	0.13
Mean BMI (SD)	32 (7.3)	28.5 (4.8)	0.06
Biliary etiology	6 (35.3)	11 (44)	0.57
ICU admission	10 (58.8)	25 (100)	< 0.001
Mean ICU LOS in days (SD)	2.4 (3.1)	15.7 (12.7)	< 0.001
Need for nutritional support	13 (76.5)	24 (96)	0.01
Pancreatic necrosis	11 (64.7)	16 (64)	0.8
Need for drainage or debridement	5 (29.4)	7 (28)	0.92
Median LOS (IQR)	19 (15-28)	22 (16-35)	0.31
Mortality	0	0

SD: Standard deviation; BMI: Body mass index; ICU: Intensive care unit; LOS: Length of stay; IQR: interquartile range.

Table 4 Specific clinical parameters of patients with isolated renal failure

Patient	Age	Gender	Etiology	Comorbidity	PNec	Peak Cr	Dialysis	Dialysis at DC	Dialysis indication	ICU	LOS
1	50	M	Post-ERCP	Cirrhosis	No	2.9	No	NA	NA	No	19
2	54	M	HTG	None	No	2.6	No	NA	NA	No	18
3	68	M	Idiopathic	Diabetes	Yes	2	No	NA	NA	Yes	19
4	64	M	Biliary	Diabetes	Yes	3.8	No	NA	NA	No	84
5	40	M	Alcohol	Cirrhosis	Yes	4.1	No	NA	NA	Yes	12
6	81	F	Biliary	None	Yes	2.2	No	NA	NA	No	15
7	32	M	Alcohol	None	Yes	3.6	No	NA	NA	No	21
8	78	F	Biliary	Diabetes	Yes	1.9	No	NA	NA	Yes	28
9	58	M	Other	None	Yes	2	No	NA	NA	No	51
10	60	F	Alcohol	None	No	2.5	No	NA	NA	Yes	26
11	81	M	Biliary	None	No	4	No	NA	NA	Yes	17
12	29	M	Other	None	Yes	7.8	Yes	No	Hyperkalemia, volume overload	Yes	30
13	41	M	HTG	Diabetes	Yes	6.6	No	NA	NA	Yes	18
14	77	M	Biliary	COPD, Diabetes	No	3.3	No	NA	NA	Yes	12
15	62	F	Post-ERCP	Cholangiocarcinoma	No	2.9	No	NA	NA	No	6
16	54	M	Biliary	None	Yes	14.6	Yes	No	Hyperkalemia	Yes	33
17	24	M	HTG	COPD	Yes	4.1	No	NA	NA	Yes	11

M: Male; F: Female; ERCP: Endoscopic retrograde cholangiopancreatography; HTG: Hypertriglyceridemia; COPD: Chronic obstructive pulmonary disease; PNec: Pancreatic necrosis; Cr: Creatinine; DC: Discharge; NA: Not applicable; ICU: Intensive care unit; LOS: Length of stay.