Association between Timing of Surgical Intervention and Mortality in 15,813 Acute Pancreatitis

OBJECTIVE: In order to find the quantitative relationship between timing of surgical intervention and risk of death in necrotizing pancreatitis. METHODS: The generalized additive model was applied to quantitate the relationship between surgical time (from the onset of acute pancreatitis to first surgical intervention) and risk of death adjusted for demographic characteristics, infection, organ failure, and important lab indicators extracted from the Electronic Medical Record of West China Hospital of Sichuan University. RESULTS: We analyzed 1,176 inpatients who had pancreatic drainage, pancreatic debridement, or pancreatectomy experience of 15,813 acute pancreatitis retrospectively. It showed that when surgical time was either modelled alone or adjusted for infection or organ failure, an L-shaped relationship between surgical time and risk of death was presented. When surgical time was within 32.60 days, the risk of death was greater than 50%. CONCLUSION: There is an L-shaped relationship between timing of surgical intervention and risk of death in necrotizing pancreatitis.