Clinical characteristics and prognosis of moderately severe acute pancreatitis and severe acute pancreatitis

Abstract

Objective To evaluate the clinical significance of a new classification of acute pancreatitis.Methods Seventy-eight patients with severe acute pancreatitis were retrospectively studied,and according to the new classification,these pancreatitis were further divided into moderately severe acute pancreatitis (MSAP) group (n =57) and severe acute pancreatitis (SAP) group (n =21).The sex ratio,age,etiology,laboratory and imaging examination after admission,APACHE Ⅱ score,Ranson score,SIRS score,modified Marshall score,JSS score,BISAP score,Imrie score,days of gastrointestinal decompression,ICU stay,hospital stay,number of surgical interventions,mortality,hospitalization expenses were documented in these two groups of patients.Results Upon admission,the sex ratio,etiology,hematocrit and SIRS score was not statistically significantly different between the two groups (P ＞ 0.05).The serum creatinine,blood urea nitrogen,lactate dehydrogenase,APACHE Ⅱ score,Ranson score,modified Marshall score,JSS score,BISAP score,and Imrie score of SAP group were (157.13 ± 101.60) μμmol/L,(10.38 ± 7.43) mmol/L,(780.62±645.01)IU/L,(13.71±5.03),(5.14±2.15),(5.48±2.36),(4.62±1.63),(2.57±0.60),(4.71 ± 1.27),and the corresponding values in MSAP group were (71.85 ± 27.90) μmol/L,(4.71 ±2.57)mmol/L,(337.70± 177.77)IU/L,(7.39±3.91),(2.49±1.56),(0.81±0.85),(2.21 ± 1.37),(1.68 ±0.81),(2.77 ± 1.24),and the difference between the two groups was statistically significant (P ＜ 0.05).All patients in SAP group had persistent organ failure,eight patients had single organ failure and thirteen patients had multiple organ failure,and nine patients died.All patients in MSAP group were cured and discharged.The number of patients in SAP group who were admitted in ICU,ICU stay,hospital stay,hospitalization expenses were 11,(8.10 ± 13.67) d,(45.8 ± 45.5) d,(114.1 ± 166.7)thousands RMB,and the corresponding values in MSAP group were 2,(0.16 ± 0.88) d,(26.3 ± 19.7) d,(36.2 ± 29.3) thousands RMB,and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions The new classification system which divides AP into MAP,MSAP,SAP can help clinicians better evaluate the severity and prognosis of patients with AP. Key words: Pancreatitis ; Retrospective studies ; Disease attributes ; Local complications ; Multiple organ failure; Prognosis