Aetiology, Severity and Outcome of Patients Admitted with Acute Pancreatitis: A Cross-Sectional Study
DOI:
https://doi.org/10.36570/jduhs.2024.1.2047Keywords:
Acute Pancreatitis , Etiologies , Mortality , SeverityAbstract
Objective: To determine the aetiology, severity and outcome of patients admitted with acute pancreatitis at Hamdard University Hospital Karachi, Pakistan.
Methods: This retrospective cross-sectional study was conducted at Hamdard University Hospital Karachi from January 2021 to June 2023. Patients aged 18 years and above who were admitted to the hospital with confirmed acute pancreatitis, admitted through the emergency department or by direct admission were included. Patient’s demographic data, aetiology, along with the severity of disease and outcome, such as alive or dead, were noted. Bedside Index of Severity in Acute Pancreatitis was used to assess the severity of the disease.
Results: Of the 188 patients, the mean age was 59.14 ±9.52 years. Mild acute pancreatitis was observed in 58 (30.9%), moderate in 95 (50.5%), and severe in 35 (18.6%) patients. Biliary pancreatitis was the most common etiology in 129 (68.6%) participants, whereas symptoms of abdominal pain and abdominal distension were observed in all 188 (100%) patients. A significant association of acute pancreatitis was observed with age (p-value <0.001), gender (p-value 0.047), length of hospital stays (p-value <0.001), and Computed Tomography Severity Index (CTSI) severity (p-value <0.001). Mortality was observed in 9 (4.8%) patients with severe acute pancreatitis.
Conclusion: In conclusion, biliary pancreatitis was the most common etiology of patients admitted with acute pancreatitis. Significant associations were found between the severity of acute pancreatitis and various factors including age, gender, hospital stay duration, and CTSI severity. The overall mortality appeared only in patients with severe acute pancreatitis.
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References
Mederos MA, Reber HA, Girgis MD. Acute pancreatitis: A review. J Amer Med Assoc 2021; 325:382-90.
doi:10.1001/jama.2020.20317
Barreto SG, Habtezon A, Gukovskaya A, Lugea A, Jeon C, Yadav D, et al. Critical thresholds: key to unlocking the door to the prevention and specific treatments for acute pancreatitis. Gut 2021; 70:194-203. doi:10.1136/gutjnl-2020-322163
Zhou Y, Ge YT, Shi XL, Wu KY, Chen WW, Ding YB, et al. Machine learning predictive models for acute pancreatitis: A systematic review. Int J Med Inform 2022; 157:104641. doi:10.1016/j.ijmedinf.2021.104641
Rahman A, O'Connor DB, Gather F, Koscic S, Gilgan J, Mockler D, et al. Clinical classification and severity scoring systems in chronic pancreatitis: a systematic review. Dig Surg 2020; 37:181-91. doi:10.1159/000501429
Colvin SD, Smith EN, Morgan DE, Porter KK. Acute panc-reatitis: an update on the revised atlanta classification. Abdom Radiol 2020; 45:1222-31. doi:10.1007/s00261-019-02214-w
Silva-Vaz P, Abrantes AM, Castelo-Branco M, Gouveia A, Botelho MF, Tralhao JG. Multifactorial cores and iomarkers of prognosis of acute pancreatitis: applications to research and practice. Int J Mol Sci 2020; 21:338. doi:10.3390/ijms21010338
Van Den Berg FF, De Bruijn AC, Van Santvoort HC, Issa Y, Boermeester MA. Early laboratory biomarkers for severity in acute pancreatitis; A systematic review and meta-analysis. Pancreatology 2020; 20:1302-11. doi:10.1016/j.pan.2020.09.007
Lee DW, Cho CM. Predicting severity of acute pancrea-titis. Medicina (Kaunas) 2022; 58:787. doi:10.3390/medicina58060787
Nesvaderani M, Eslick GD, Vagg D, Faraj S, Cox MR. Epidemiology, aetiology and outcomes of acute pancreatitis: A retrospective cohort study. Int J Surg 2015; 23:68-74. doi:10.1016/j.ijsu.2015.07.701.
Zhu Y, Pan X, Zeng H, He W, Xia L, Liu P, et al. A study on the etiology, severity, and mortality of 3260 patients with acute pancreatitis according to the revised atlanta classification in Jiangxi, China over an 8-Year period. Pancreas 2017; 46:504-09.
doi:10.1097/MPA.0000000000000776
Chatterjee R, Parab N, Sajjan B, Nagar VS. Comparison of acute physiology and chronic health evaluation ii, modified computed tomography severity index, and bedside index for severity in acute pancreatitis score in predicting the severity of acute pancreatitis. Indian J Crit Care Med 2020; 24:99-103. doi:10.5005/jp-journals-10071-23343
Hagjer S, Kumar N. Evaluation of the bisap scoring sys-tem in prognostication of acute pancreatitis-a prospective observational study. Int J Surg 2018; 54:76-81.doi:10.1016/j.ijsu.2018.04.026
Janjua SS, Zaman F, Qamar T. Comparison of ranson's score, bisap, and ctsi in predicting the severity of acute pancreatitis. J Islamabad Med Dent College 2018; 7:255-9. doi:10.35787/jimdc.v7i4.256
Harshit Kumar A, Singh Griwan M. A comparison of APACHE II, BISAP, Ranson's score and modified CTSI in predicting the severity of acute pancreatitis based on the 2012 revised Atlanta Classification. Gastroenterol Rep 2018; 6:127-31. doi:10.1093/gastro/gox029
Chatterjee R, Parab N, Sajjan B, Nagar VS. Comparison of acute physiology and chronic health evaluation ii, modified computed tomography severity index, and bedside index for severity in acute pancreatitis score in predicting the severity of acute pancreatitis. Indian J Crit Care Med 2020; 24:99-103. doi:10.5005/jp-journals-10071-23343
Capurso G, Ponz de Leon Pisani R, Lauri G, Archibugi L, Hegyi P, Papachristou GI, et al. Clinical usefulness of scoring systems to predict severe acute pancreatitis: A systematic review and meta-analysis with pre and post-test probability assessment. United European Gastroenterol J 2023; 11:825-36. doi:10.1002/ueg2.12464
Zhao Y, Xia W, Lu Y, Chen W, Zhao Y, Zhuang Y. Predictive value of the c-reactive protein/albumin ratio in severity and prognosis of acute pancreatitis. Front Surg 2023; 9:1026604. doi:10.3389/fsurg.2022.1026604
Zhao Z, Yu Y, Xie R, Yang K, Xu D, Li L, et al. Prognostic value of the creatinine-albumin ratio in acute pancreatitis debridement. BMC Surg 2020; 20:322. doi:10.1186/s12893-020-00991-6
Tarar MY, Khalid A, Choo XY, Khurshid S, Tumeh H, Muhammad K. Use of the c-reactive protein (crp)/ albumin ratio as a severity tool in acute pancrea-titis: Systematic review. Cureus 2022; 14:e29243. doi:10.7759/cureus.29243
Nawaz A, Khan AH, Farrukh R, Mahmood K, Hayat N, Nazir A. Frequency of silent gallstones in acute pancreatitis. InMed Forum 2021; 32:120.
Mumtaz N, Arif A, Shah SN, Samo A. The prevalence of gall stones in acute pancreatitis a prospective view from lady reading hospital mti peshawar kp. Pak J Med Health Sci 2022; 16:62-4. doi:10.53350/pjmhs2216962
Rasineni K, Srinivasan MP, Balamrugan AN, Kaphalia BS, Wang S, Ding WX, et al. Recent advances in understanding the complexity of alcohol-induced pancreatic dysfunction and pancreatitis development. Biomolecules 2020; 10:669.
doi:10.3390/biom10050669
Matta B, Gougol A, Gao X, Reddy N, Talukdar R, Kochhar R, et al. Worldwide variations in demographics, management, and outcomes of acute pancreatitis. Clin Gastroenterol Hepatol 2020; 18:1567-75. doi:10.1016/j.cgh.2019.11.017
Hameed T, Khan AZ, Shah I, Khan AQ, Ahmad M. Factors leading to acute pancreatitis in tertiary care hospitals in Pakistan–a multicenter study. J Rawal Med Coll 2018; 22:50-3.
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