Clinical Profile and Outcomes in Patients with Acute Pancreatitis attending a Teaching Hospital at Gandaki Province, Nepal

Abstract

Background: Acute pancreatitis (AP) is inflammatory process of pancreas presenting with acute abdominal pain.The majority of patients have mild disease. Some patients develop local and systemic complications with increased morbidity and mortality. This study was undertaken to describe the clinical profile and outcomes in patients with acute pancreatitis.
 
 Methods: A cross-sectional hospital based study comprising of 62 consecutive patients with acute pancreatitis were enrolled between Jan 2019 to August 2020. Clinical profile at admission, complications and clinical outcomes including mortality were studied. Patients were classified into mild, moderately severe and severe acute pancreatitis based on revised Atlanta classification and modified CT severity index. Data entry was done in Statistical Packages for the Social Sciences version 20.
 Results: The mean age of study subjects was 44±10.87 years with 43 (56%) males and 19 (44%) females (M:F=2.1:1). The commonest etiology of pancreatitis was alcohol (53.2%) followed by biliary pancreatitis (37.1%) The most common presentation was abdominal pain (100%). The most common complication was pancreatic necrosis (21%) followed by acute kidney injury (19.4%) and pleural effusion (17.3%). Majority( 72.6%) was mild and 17.7% had severe acute pancreatitis. Mortality was seen in 6.5% patients. Mortality was observed in patients with persistent complications, organ failure, low serum calcium and high modified CT severity index.
 
 Conclusions: Alcohol and gallstones were the two main etiologies of acute pancreatitis and were common in males, and in middle age groups. Majority presented with mild severity. Mortality was observed in some patients with severe acute pancreatitis.
 
 Keywords: alcohol; biliary; CT severity index; mortality; outcome; pancreatitis
 
 
 
 

Clinical Profile and Outcome of Acute Pancreatitis in a Tertiary Health Care Center of Nepal

“…More than 3 folds raised amylase and/or lipases were seen in 82.7 of patients. Similar to this study, more than 3 folds rise in amylase/lipase was seen in 87.1%, 81% and 82% in study by Bhattrai et al, 8 Reid et al 13 and Rao et al 14…”

“…The most common presentation in our study was abdominal pain (97%) followed by vomiting (66.7%) and fever (17.3%). Pain abdomen (100%) followed by vomiting (42.27%) by Negi et al, 10 abdominal pain (100%) followed by nausea (83.9%), vomiting (66.1%)by Bhattrai et al 8 and abdominal pain (79%), vomiting (71.4%) and fever (23.8%) by Reid et al 13 all studies on acute pancreatitis showed presenting symptoms similar to our study. More than 3 folds raised amylase and/or lipases were seen in 82.7 of patients.…”

Acute Pancreatitis among Patients Visiting the Department of Surgery in a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…In our study 85% of the patients with acute pancreatitis presented with nausea and vomiting. Similarly, 83.9% 24 and 90% of patients presented with nausea and vomiting respectively in other studies. 25 Our study showed the three-fold rise in serum amylase and serum lipase to be present in 50% and 36.67% of the patients admitted with acute pancreatitis respectively.…”

“…27 Likewise, our study showed leukocytosis (TLC>11,000/ mm 3 ) in 23.33% of the patients with acute pancreatitis, Free Full Text Articles are Available at www.jnma.com.np which is lower than the findings from the studies which showed leukocytosis in two-thirds of the patients. 24,26 Previous studies have reported decreased serum calcium among 8.6% 25 and 18% 26 of the patients with acute pancreatitis. The findings from these studies were similar to our study where 8.3% of the patients having acute pancreatitis presented with hypocalcemia (<8.5 mEq/L).…”

“…27 In contrast to that, another study showed no link between raised CRP and mortality. 24 CRP levels at the time of admission have been found to predict severity poorly, however, CRP >150 mg/dL within the first 48 hours has shown high sensitivity for predicting the severity of acute pancreatitis. 28,29 In our study, 69.7% of patients with normal serum creatinine had mild acute pancreatitis.…”