Factors affecting mortality and morbidity in acute pancreatitis
Factors affecting mortality and morbidity in acute pancreatitis
We aimed to reveal the parameters that may be early predictors of mortality and morbidity by examining the data of patients with acute pancreatitis. In this study, demographic, clinical and biochemical parameters of 273 patients treated with the diagnosis of acute pancreatitis between 2010 and 2016 were scanned. Age, sex, comorbidity, history of operation, application method, clinical information about the etiology of pancreatitis, hemogram and biochemical parameters, Ranson values, morbidity and mortality findings were recorded. Of the 273 patients, whose mean age ranged from 18 to 98 (mean±sd: 56.94±19.21), 105 were male and 168 were female. Mortality developed in 3% of the patients (n=8), and a statistically significant difference was found between patients with and without mortality concerning age, the time between symptom and admission, presence of comorbidity, operation, Ranson scores, hypocalcemia and CRP values. Morbidity developed in 49.1% (n=134) of the patients, and when the patients with and without morbidity were compared, statistically significant difference was found concerning the female sex, presence of comorbidity, hyperglycemia, neutrophil to lymphocyte ratio (NLR), BUN, ALT, GGT, CRP, BUN, Ca values and Ranson scores. According to the Logistic Regression Analysis of the parameters that give significant results, Ranson 48th-hour measurements, admission time and age can predict mortality best, respectively, while 48th-hour Ranson value, CRP and NLR can best predict morbidity, respectively.
___
- 1. Bhatia M, Wong FL, Cao Y, et al. Pathophysiology of acute pancreatitis. Pancreatology. 2005;5:132-44.
- 2. Cappell MS. Acute pancreatitis: etiology, clinical presentation, diagnosis, and therapy. Med Clin North Am. 2008;92:889-923.
- 3. Chatila AT, Bilal M, Guturu P. Evaluation and management of acute pancreatitis. World J Clin Cases. 2019;7:1006-20.
- 4. Franco-Pons N, Gea-Sorlí S, Closa D. Release of inflammatory mediators by adipose tissue during acute pancreatitis. J Pathol. 2010;221:175-82.
- 5. Popa CC, Badiu DC, Rusu OC, Grigorean VT, Neagu SI, Strugaru CR. Mortality prognostic factors in acute pancreatitis. J Med Life. 2016;9:413-8.
- 6. Harris HW, Barcia A, Schell MT, et al. Necrotizing pancreatitis: a surgical approach independent of documented infection. HPB (Oxford). 2004;6:161-8.
- 7. Zerem E. Treatment of severe acute pancreatitis and its complications. World J Gastroenterol. 2014;20:13879-92.
- 8. Munigala S, Yadav D. Case-fatality from acute pancreatitis is decreasing but its population mortality shows little change. Pancreatology. 2016;16:542-50.
- 9. Sarri G, Guo Y, Iheanacho I, et al. Moderately severe and severe acute pancreatitis : a systematic review of the outcomes in the USA and European Union-5 BMJ Open Gastroenterology 2019;6:e000248.
- 10. Gapp J, Chandra S. Acute Pancreatitis. [Updated 2021 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.
- 11. Phillip V, Steiner JM, Algul H. Early phase of acute pancreatitis: assessment and management. World J Gastrointest Pathophysiol. 2014;5:158-68.
- 12. Shen H, Chang Y, Chen H, et al. Increased risk of severe acute pancreatitis in patients with diabetes. Diabet Med. 2012;29:1419-24.
- 13. Yang L, He Z, Tang X, Liu J. Type 2 diabetes mellitus and the risk of acute pancreatitis: a meta-analysis. Eur J Gastroenterol Hepatol. 2013;25:225-31.
- 14. Suppiah A, Malde D, Arab T, et al. The prognostic value of the neutrophil– lymphocyte ratio (NLR) in acute pancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013;17:675-81.
- 15. Wu BU, Bakker OJ, Papachristou GI, Besselink MG, Repas K, van Santvoort HC, et al. Blood urea nitrogen in the early assessment of acute pancreatitis: an international validation study. Arch Intern Med. 2011;171:669-76.
- 16. Gonzálvez-Gasch A, Casasola GG, Martín RB, et al. A simple prognostic score for risk assessment in patients with acute pancreatitis. Eur J Intern Med. 2009;20:e43-8.
- 17. Johnson CD, Abu-Hilal M. Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis. Gut. 2004;53:1340-4.
- 18. Lee W-S, Huang J-F, Chuang W-L. Outcome assessment in acute pancreatitis patients. Kaohsiung J Med Sci. 2013;29:469-77.