Abstract
This tertiary care hospital based retrospective study was performed to find out the prognostic factors and clinical outcome of acute pancreatitis from the available clinical, biochemical, haematological and radiological data. A total of 307 cases were studied. Peak incidence was in the fourth decade. Among the known aetiological factors 18% were due to gallstone disease, 10% alcoholism, 4% viral, but 60% were idiopathic. In this study 82% patients were had mild and 18% had severe acute pancreatitis. Overall mortality rate was 6%, mortality was significantly higher (33.33%) in severe acute pancreatitis (33.3% vs 0%). A higher mortality was associated with concomitant medical or surgical diseases, leucocytosis. Other factors associated with a higher mortality were high blood glucose, serum creatinine level and a lower serum albumin and calcium level. This study highlights importance of routine investigations and guides the primary care hospital for early intervention and referral for higher centre.
Keyword: Acute Pancreatitis, Prognosis, Mortality.
References
- Bradley El. 3rd: A clinically based classification system for acute pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch surg. 1993;128:586.
- Sargen K, Kingsnorth A. Management of Gallstone Pancreatitis: Effects of Deviation from Clinical Guidelines. J Pancreas (Online) 2001; (5):317 -322.
- Singh VK, Bollen TL, Wu BU, et al. An assessment of the severity of interstitial pancreatitis. ClinGastroenterolHepatol 2011; 9:1098.
- Corfield AP, Cooper Ml, Williamson RCN. Acute pancreatitis: A lethal disease of increasing significance. Gut. 1985;26:724.
- Zheng Y, Zhou Z, Li H, et al. A multicenter study on etiology of acute pancreatitis in Beijing during 5 years.Pancreas.2015 Apr;44(3):409-14.
- Beger HG, Rau BM. Severe acute pancreatitis: Clinical course and management. World J Gastroenterol 2007;13:5043.
- Wyncell DL. The management of severe acute necrotizing pancreatitis: an evidence-based review of the literature.Intensive Care Med 1999; 25: 146.
- Steinberg WT. Acute pancreatitis. N Engl J Med 1994; 330:1198
- Forsmark CE, Baillie J, AGA Institute Clinical Practice and Economics Committee, AGA Institute Governing Board. AGA Institute technical review on acute pancreatitis. Gastroenterology 2007;132:2022.
- Tenner S, Baillie J, DeWitt J, et al. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol 2013; 108:1400.
- Chauhan S, Forsmark CE. The difficulty in predicting outcome in acute pancreatitis. Am J Gastroenterol 2010; 105:443.
- Johnson CD, Abu-Hilal M. Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis. Gut 2004; 53:1340.
- Dervenis C, Bassi C. Evidence-based assessment of severity and management of acute pancreatitis. Br J Surg 2000; 87:257-258.
- Beger HG, Rau B, Mayer J, Pralle U. Natural course of acute pancreatitis. WorldJ Surg. 1997;21:130-5.
- Dervenis C, Johnson CD, Bassi C. Diagnosis, objective assessment of severity,and management of acute pancreatitis. Int J Pancreatol. 1999;25:195210.
- Mayor AD, McMahon MJ. Gallstones and acute pancreatitis- is the association underestimated? Br J Surg. 1984;71:905.
- Corfield AP, Cooper Ml, Williamson RCN. Acute pancreatitis: A lethal disease of increasing significance. Gut. 1985;26:724.
- Economou, M. Zissis. Infectious cases of acute pancreatitis. Annals of Gastroenterology 2000;13(2):98-101
- Ranson JHC. Prognostic signs and the role of operative management in acute pancreatitis. SurgGynoclObstet 1994;139: 69-81
- Funnell IC, Bomman PC, Weakley SP. Obesity: An important prognostic factor in acute pancreatitis. Br I Surg. 1993;80:484.
- Houssin D, Castain GD, Lemoine J, Bismuth H. Microlithiasis of gall bladder. SurgGynecol Obstet. 1983;157:20-4.
- Balthazar EJ, Freeny PC, van Sonnenberg E. Imaging and intervention in acute pancreatitis. Radiology. 1994;193:297-306.
- Kanus WA, Draper EA, Wagner DP, Zimmerman JE. APPACHE II: A severity of disease classification system. Crit Care Med 1985; 13: 18-829.
- Beger HG, Bittner R, Silvia Block, Bqchler M. Bacterial contamination of pancreatic necrosis: a prospective clinical study. Gastroenterology 1986; 91:433– 8.
- Lece T, Shaw D. Comparison of three Glasgow multifactor prognostic scoring systems in acute pancreatitis. Br J Surg 1988; 75:460-463.
- Fan ST, Lai EC, Mok FP. Early treatment of acute biliary pancreatitis by endoscopic papillotomy. N EnglJMed 1993; 328: 228.
- Brisando G, Maria G, Ferrante A, Civello IM. Evaluation of prognostic factors in patients with acute pancreatitis. HepaGastroenterol 1999; 46: 1990-1997
- Norman J. The Role of cytokines in the pathogenesis of acute pancreatitis. Am J surg 1998; 175: 76.
Corresponding Author
Dr Ananth S Mathad
Postgraduate, Dept of General Surgery, SSIMS&RC, Davangere
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.08
