DEVELOPMENT OF A STRATIFICATION SYSTEM FOR SEVERE ACUTE PANCREATITIS IN THE FIRST DAY OF ITS ONSET

Abstract

Introduction. Acute pancreatitis stands as one of the prevalent acute inflammatory diseases of the abdominal cavity, marked by a diverse range of clinical presentations and the risk of developing persistent organ failure is too high even in its early stages. At present, the widely adopted framework for assessing acute pancreatitis is the 2012 revised Atlanta classification. However, distinguishing between moderately severe and severe acute pancreatitis within this classification necessitates a minimum of 48 hours to determine the persistence of organ failure. Consequently, the primary challenge in contemporary acute pancreatitis diagnosis and treatment lies in the imperative task of early-stage prognosis and effective stratification of disease severity.
 Objective of this investigation is to determine the availability of optimal parameters of clinical and instrumental examination methods in order to predict the course of acute pancreatitis in the first day of its onset by conducting a statistical analysis of the studies performed.
 Materials and methods. The assessment the state of microcirculation in patients by the method of laser Doppler flowmetry was carried out using the LAKK-02 device according to the specified methodology. Patients were also subjected to general clinical and instrumental examination. In order to study the influence of indicators on the severity of the disease, the paired correlation coefficients of each of them were calculated, after which, for the parameters with the closest connection, a multiple linear correlation-regression model was built and the multiple correlation coefficient with the severity of the disease was calculated.
 Results. The following parameters have the most significant influence on the severity of the disease on the first day: findings of laser Doppler flowmetry C (A/M), systemic inflammatory response syndrome criteria, hematocrit, hydrothorax/peritonitis. In the complex analysis, the multiple correlation coefficient is 0.803, which indicates a significant relationship between the factors included in the model and the degree of severity. The coefficient of determination points out that the degree of severity is 64.5% dependent on the indicators included in the model.
 Conclusions. The obtained results of the study indicate the presence of a complex influence of the criteria of laser Doppler flowmetry C (A/M), criteria of the systemic inflammatory response syndrome, hematocrit, hydrothorax/peritonitis on the severity of the disease in patients with acute pancreatitis within the first day of the disease onset that underscores the potential for early-stage preliminary stratification of acute pancreatitis severity based on these criteria.