EGS P18 A single centre retrospective audit into the early management of acute pancreatitis in an UK District General hospital

Abstract

Abstract Background In the UK, the incidence of acute pancreatitis is approximately 56 case per 100,000 people per year. It is a complex disease, and the treatment of pancreatitis can vary significantly between different regions regardless of the numerous national and international guidelines.The purpose of this audit is to compare the diagnosis and management of pancreatitis at Ipswich hospital with other hospitals that have participated in the PANC study. We also compared the ideology and mortality rate. By doing so, we can establish a foundation for future management plans and guidelines at Ipswich hospital. Methods This audit was conducted at Ipswich hospital for four months, from November 1st, 2022 to April 30th, 2023. It was a single-centre prospective cohort study that included all patients diagnosed with pancreatitis in accordance with the Modified Atlanta Classification and presented within the four months. Data was collected from the time of admission to discharge or death and included patient demographics, bloods on admission, investigations, aetiology, management and complications. Results A total of 87 patients were admitted to Ipswich hospital with a diagnosis of pancreatitis during this time frame.The most common etiology was gallstones(45%,PANC 50.6%),followed by idiopathic(33%,PANC 22.4%)and lastly EtOH(18%).Only 45% of those with idiopathic pancreatitis underwent further idiopathic pancreatitis screen and 10% had EUS.The most common imaging used was CT scan (51%, PANC 53%), majority of those scans were performed within the first 24 hours of admission and 33% of patients with diagnostic amylase underwent a CT. 55% of patients were started on antibiotic in the first 48 hours of admission (PANC 34.6%). Conclusions The data collected from within Ipswich hospital was similar to that found in the PANC study. This suggests that the diagnosis and management of pancreatitis is somewhat similar across the UK. The rate of Idiopathic pancreatitis was much higher than expected and higher than the PANC study. Similar to the PANC study, there is an overuse of CT scan for diagnosis of pancreatitis which is not in accordance with the royal college of radiology guidelines.