Objective: To retrospectively analyze 85 hospitalized nonoperative patients with severe acute pancreatitis (SAP) and to find out the stages of the disease.
Methods: We statistically calculated the time of onset of complications in these patients from 1987 to 1999.
Results: The 95% confidence interval of total average for the complications of acute respiratory distress syndrome (ARDS), shock and kidney failure was between 2 to 4 days, and for encephalopathy, hemorrhage of the digestive tract, bacterial infection, fungous infection and abscess between 3 to 6 days, 3 to 5 days, 13 to 16 days, 13 to 16 days, and 14 to 23 days respectively. The 95% confidence interval of total average in 18 deaths (21%) was between 5 to 6 days. ARDS, kidney failure, and shock occurred within 4 days, encephalopathy within 6 days (average 4.8±0.9 days), abscesses after 14 days, systemic bacterial infection and fungous infection within half a month (average 14.6±1.1 days, 14.8±0.9 days respectively), and death within 6 days.
Conclusion: According to the time of the occurrence of complications, we divide the courses of the disease into three stages: early phase (first 4 days) with ARDS, kidney failure, shock, encephalopathy and hemorrhage of the digestive tract; middle phase (5-15 days) with bacterial infection and fungous infection; late phase (15 days after the onset) with abscess.