Abstract
Background: Acute pancreatitis (AP) is an inflammatory process with a highly variable clinical course. This study was conducted to compare the multifactor vs independent marker in predicting the severity of acute pancreatitis. Subjects and Methods: The present study comprised of 50 patients of acute pancreatitis. In all patients, reactive protein (CRP), Interleukin-6 (IL-6), PMN-Elastase (PMN-E), Procalcitonin (PCT), RANSON”s score, GLASGOW score, APACHE-II score, APACHE-O score and Balthazar’s CTSI score was recorded. Results: There were 45 males and 5 females in the study. There were 12 (22.64%) obese patients in this study. The age of the patients was a significant indicator to discriminate or predict patients with mild or severe pancreatitis. With an AUROC of 0.6004, it was found that age was a poor predictor of the severity of acute pancreatitis. Obesity of the patients was a significant indicator to discriminate or predict patients with mild or severe pancreatitis. With an AUROC of 0.6004, it was found that age is a poor predictor of the severity of acute pancreatitis. Organ failure at admission is more likely to reflect severe cases, it is found to be a poor predictor of severity in acute pancreatitis. The mean CTSI score in the study was 3.57 (SD 2.64), with a median of 2 and ranged from 1 to 10. It was higher in severe pancreatitis and a CTSI score of >=3 was significantly associated with patients with acute pancreatitis by bivariate analysis. Conclusion: The authors found that overall, CRP was the best predictor, followed by IL-6, CTSI score, PCT, Glasgow, Ranson’s and APACHE-II. PMN-Elastase, Age, obesity and organ failure at admission are poor predictors of severity of acute pancreatitis.
Highlights
Acute pancreatitis (AP) is an inflammatory process with a highly variable clinical course. [1] Most patients with AP have a mild disease that resolves spontaneously without sequelae
[Figure 5] shows that the Glasgow score of the patients in the study ranged from 0 to 5 with a mean (SD) of 1.38 (1.43) and a median of 1. It was higher in severe pancreatitis and a score of >=3 was significantly associated with patients with acute pancreatitis by bivariate analysis
[Figure 8] shows that the mean computed tomography severity index (CTSI) score in the study was 3.57 (SD 2.64) with a median of 2 and ranged from 1 to 10. It was higher in severe pancreatitis and a CTSI score of >=3 was significantly associated with patients with acute pancreatitis by bivariate analysis
Summary
Acute pancreatitis (AP) is an inflammatory process with a highly variable clinical course. [1] Most patients with AP have a mild disease that resolves spontaneously without sequelae. Acute pancreatitis (AP) is an inflammatory process with a highly variable clinical course. 10%-20% of patients experience a severe attack with high mortality of up to 30%. Most patients with acute pancreatitis have a mild form of the disease that will respond to supportive treatment. 20% of affected individuals will develop a severe clinical course in association with the development of a systemic inflammatory response syndrome (SIRS), multiple organ failure (MOF), and on occasion, death. Many guidelines have recommended using APACHE II and Ranson scores to assess disease severity at 24-48 h after admission. [5] specific instructions recommend using computed tomography severity index (CTSI) scores ≥3, C-reactive protein (CRP) levels ≥150 mg/L and hematocrit (HCT) levels ≥44 to predict SAP. Bada: Multifactor Vs Independent Marker in Acute Pancreatitis multifactor vs independent marker in predicting the severity of acute pancreatitis
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