• Daniel R J Wolbrink, van de PollMarcel C GMCGDepartment of Intensive Care Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.De, Fabian Termorshuizen, Nicolette F de Keizer, van der HorstIwan C CICCDepartment of Intensive Care Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands., Ronny Schnabel, DejongCees H CCHCDepartment of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands., Hjalmar C van Santvoort, Marc G Besselink, Harry van Goor, BouwenseStefan A WSAWDepartment of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands., Bas C T van Bussel, and Dutch Pancreatitis Study Group and the Dutch National Intensive Care Evaluation (NICE) Collaborators.
• Department of Surgery, Radboudumc, Nijmegen, The Netherlands.
• Crit. Care Med. 2022 Oct 1; 50 (10): 151315211513-1521.

ObjectivesTo investigate national mortality trends over a 12-year period for patients with severe acute pancreatitis (SAP) admitted to Dutch ICUs. Additionally, an assessment of outcome in SAP was undertaken to differentiate between early (< 14 d of ICU admission) and late (> 14 d of ICU admission) mortality.DesignData from the Dutch National Intensive Care Evaluation and health insurance companies' databases were extracted. Outcomes included 14-day, ICU, hospital, and 1-year mortality. Mortality before and after 2010 was compared using mixed logistic regression and mixed Cox proportional-hazards models. Sensitivity analyses, excluding early mortality, were performed to assess trends in late mortality.SettingNot applicable.PatientsConsecutive adult patients with SAP admitted to all 81 Dutch ICUs between 2007 and 2018.InterventionsNot applicable.Measurements And Main ResultsAmong 4,160 patients treated in 81 ICUs, 14-day mortality was 17%, ICU mortality 17%, hospital mortality 23%, and 1-year mortality 33%. After 2010 in-hospital mortality adjusted for age, sex, modified Marshall, and Acute Physiology and Chronic Health Evaluation III scores were lower (odds ratio [OR], 0.76; 95% CI, 0.61-0.94) than before 2010. There was no change in ICU and 1-year mortality. Sensitivity analyses excluding patients with early mortality demonstrated a decreased ICU mortality (OR, 0.45; 95% CI, 0.32-0.64), decreased in-hospital (OR, 0.48; 95% CI, 0.36-0.63), and decreased 1-year mortality (hazard ratio, 0.81; 95% CI, 0.68-0.96) after 2010 compared with 2007-2010.ConclusionsOver the 12-year period examined, mortality in patients with SAP admitted to Dutch ICUs did not change, although after 2010 late mortality decreased. Novel therapies should focus on preventing early mortality in SAP.Copyright © 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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