Abstract
Acute pancreatitis, the most frequent hospitalization reason in internal medicine ward among gastrointestinal diseases, is burdened by high mortality rate. The disease manifests mainly in a mild form, but about 20-30% patients have a severe progress that requires intensive care. Patients presenting with acute pancreatitis should be clinically evaluated for organ failure signs and symptoms. Stratifying patients in the first days from symptoms onset is essential to determine therapy and care setting. The aim of our study is to evaluate prognostic factors for acute pancreatitis patients, hospitalized in internal medicine wards, and moreover, understanding the role of various prognostic scores validated in intensive care setting in predicting in-hospital mortality and/or admission to intensive care unit. We conducted a retrospective study enrolling all patients with diagnosis of acute pancreatitis admitted took an internal medicine ward between January 2013 and May 2019. Adverse outcome was considered in-hospital mortality and/or admission to intensive care unit. In total, 146 patients (137 with positive outcome and 9 with adverse outcome) were enrolled. The median age was (67.89 ± 16.44), with a slight prevalence of male (55.1%) compared to female (44.9%). C protein reactive (p = 0.02), creatinine (p = 0.01), sodium (p = 0.05), and troponin I (p = 0.013) after 48 h were significantly increased in patients with adverse outcome. In our study, progression in SOFA score independently increases the probability of adverse outcome in patients hospitalized with acute pancreatitis. SOFA score > 5 is highly predictive of in-hospital mortality (O.R. 32.00; C.I. 6.73-152.5; p = 0.001) compared to other scores. The use of an easy tool, validated in intensive care setting such as SOFA score, might help to better stratify the risk of in-hospital mortality and/or clinical worsening in patients hospitalized with acute pancreatitis in internal medicine ward.
Highlights
The number of hospitalizations for acute pancreatitis (AP) has doubled over the two last decades [1, 2]
Stratifying the patients according to classification of Atlanta, we find 122 mild pancreatitis, 8 moderately severe, 16 severe
Patients with severe AP were significantly older than patients with mild-moderate pancreatitis (p = 0.025) (Table 1)
Summary
The number of hospitalizations for acute pancreatitis (AP) has doubled over the two last decades [1, 2]. AP is the leading cause of hospitalization in the USA in internal medicine wards among gastrointestinal diseases and is burdened by a high mortality rate [3, 4]. The disease manifests in a mild form, but about 20-30% of patients have a severe evolution associated with a single or multi-organ failure that requires. Para et al Journal of Genetic Engineering and Biotechnology (2021) 19:77 different prognostic scores, validated in setting different from internal medicine in predicting mortality among patients with AP diagnosis
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