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Vol.5 , No. 3, Publication Date: Jun. 1, 2018, Page: 65-68
, patients were categorized into mild, moderate and severe form of acute pancreatitis. Other investigations like full blood count, liver and renal function tests, serum amylase, lipase, blood sugar random, fasting lipid profile and serum calcium were done for all the patients as routine. CT severity index was calculated by the radiologist using Balthazar score when Contrast enhanced CT scan abdomen was indicated in certain deteriorating patients. Using a step up approach, surgical intervention was done in those patients whose condition deteriorated despite intensive medical management. In the study, there were 324 patients with mean age of 41.21+/-15.08 years ranging between 14-67 years of age. Overall morbidity development was 54.37% among the patients presenting with acute pancreatitis. 20 patients developed local complications needing necrosectomy and drainage of abcesses and 7 died in the course of illness. ICU admissions were 25% and Overall mortality was 16.04%. Admission value of LDH (p<0.0001), total leucocyte count (p<0.0001) and serum Lipase (p<0.0001) were significantly correlated with development of morbidity and mortality. However Amylase level (p<0.0001), Ranson’s score (p=0.769) and Glasgow scale (p=0.646) did not correlate significantly with mortality and morbidity, concluding that LDH, Lipase and Total leucocyte count can predict outcomes of patients with acute pancreatitis supplemented by clinical judgement.&picture=http://www.aascit.org/aascit/decorators/img/journal/972.jpg)
| [1] | Atif Sharif, Department of Surgery, Benazir Bhutto Hospital, Rawalpindi, Pakistan. |
| [2] | Tasleem Akhtar, Department of Surgery, Benazir Bhutto Hospital, Rawalpindi, Pakistan. |
| [3] | Mumtaz Akhtar, Department of Surgery, Al Nafees Medical College, Islamabad, Pakistan. |
| [4] | Muhammad Hanif, Department of Surgery, Benazir Bhutto Hospital, Rawalpindi, Pakistan. |
| [5] | Naeem Zia, Department of Surgery, Benazir Bhutto Hospital, Rawalpindi, Pakistan. |
Acute pancreatitis is a common disease with multiple scoring systems to predict severity of disease. This observational, prospective study was carried out at Benazir Bhutto Hospital, Rawalpindi from June, 2013 to January, 2016. On the basis of Glasgow scoring, Ranson’s scoring and CT scan severity index (CTSI), patients were categorized into mild, moderate and severe form of acute pancreatitis. Other investigations like full blood count, liver and renal function tests, serum amylase, lipase, blood sugar random, fasting lipid profile and serum calcium were done for all the patients as routine. CT severity index was calculated by the radiologist using Balthazar score when Contrast enhanced CT scan abdomen was indicated in certain deteriorating patients. Using a step up approach, surgical intervention was done in those patients whose condition deteriorated despite intensive medical management. In the study, there were 324 patients with mean age of 41.21+/-15.08 years ranging between 14-67 years of age. Overall morbidity development was 54.37% among the patients presenting with acute pancreatitis. 20 patients developed local complications needing necrosectomy and drainage of abcesses and 7 died in the course of illness. ICU admissions were 25% and Overall mortality was 16.04%. Admission value of LDH (p<0.0001), total leucocyte count (p<0.0001) and serum Lipase (p<0.0001) were significantly correlated with development of morbidity and mortality. However Amylase level (p<0.0001), Ranson’s score (p=0.769) and Glasgow scale (p=0.646) did not correlate significantly with mortality and morbidity, concluding that LDH, Lipase and Total leucocyte count can predict outcomes of patients with acute pancreatitis supplemented by clinical judgement.
Keywords
Acute Pancreatitis, Ranson Score, Glasgow Score, APACHE II, Necrosectomy
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