Severe acute pancreatitis: Impact of organ failure on mortality

Severe acute pancreatitis, as defined by the Atlanta criteria, is heterogeneous in terms of outcomes, such as organ failure, morbidity and mortality. A group of patients will have early organ dysfunction within the first 7-10 days after onset of symptoms. If the dysfunction resolves within 48 hours it is associated with low mortality. However, if it is unresolved or progresses it carries a mortality of up to 50%. Yet others will have pancreatic/peri-pancreatic necrosis with no or reversible organ failure. Such patients do not die from the disease, but have prolonged hospital stay and increased morbidity. Early aggressive hydration, a simple but often overlooked intervention, could be key to preventing organ dysfunction in acute pancreatitis.