Abstract
Clinical severity of Acute Pancreatitis (AP) following the use of Aspirin is inconclusive in previous studies. This study investigated predicting the severity of AP using Ranson criteria at admission and at 48 hours and, the length of hospital stay by prior aspirin use. Medical records of first-presentation AP patients during the five years between 2010 and 2015 were examined in the Goulburn Valley Base Hospital, Victoria, Australia. Uses of aspirin at admission with some co-morbidity, Ranson criteria at admission and at 48 hours, duration of hospital stay including other information were collected. A total of 245 AP medical records were reviewed, of them, 178 used and 67 did not use aspirin prior attending to the hospital. In simple regression analysis, Ranson score was 60% higher at admission (P< 0.001) and 64% higher at 48 hours (P <0.01) among aspirin users compared to non-aspirin users. These findings remained statistically significant after adjusting for other potential indicators. Aspirin use was also found associated with a longer hospital stay both in the unadjusted and adjusted analysis (P<0.01). Further studies using revised Atlanta classification instead of Ranson scoring for the diagnosis of AP severity in aspirin users are critical for clinical guidance.
Highlights
Acute pancreatitis (AP) is a common cause of hospital admission [1]
Prevalence of diabetes mellitus and hypertension was significantly higher among aspirin users
The average length of hospital stay for AP patients was significantly higher (6.9 days vs 4.7 days) in the aspirin using group compared to the non-aspirin using group (P
Summary
Current management is aimed at symptomatic relief of the inflammatory cascade [2, 3]. Pancreatic acinar cell injury causes the release of pro-inflammatory markers, which in turn sets off a cascade of systemic inflammation [4]. The broad spectrum of clinical disease is due to the balance of pro and anti-inflammatory responses, which ranges from self-limiting pancreatic inflammation to systemic inflammatory response syndrome (SIRS) and multi-organ failure [4]. Non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin act by inhibiting the COX (cyclooxygenase) 1 and 2 enzymes that mediate systemic inflammation [5]. A NSAID, has a broad spectrum of clinical indications due to its analgesic, antipyretic, anti-inflammatory, and antiplatelet effects. Used for primary and secondary prophylaxis against cardiovascular events, there is current interest in its protective role against colorectal cancer [7]
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