Revised Marshall Score: A New Approach to Stratifying the Severity of Acute Pancreatitis

2019 ◽  
Vol 64 (12) ◽  
pp. 3610-3615
Author(s):  
Yazan Abu Omar ◽  
Bashar M. Attar ◽  
Rohit Agrawal ◽  
Tejinder Randhawa ◽  
Muhammad Majeed ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
New Approach ◽  
Marshall Score

scholarly journals Neutrophil to lymphocyte ratio (NLR) in acute pancreatitis as an early predictor of severity and outcome

2018 ◽  
Vol 5 (11) ◽  
pp. 3545
Author(s):  
Noor Mohammed Shawnas Bhanou ◽  
Gayatri Balachandran ◽  
Nisha B. Jain
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Stay ◽  
Organ Failure ◽  
Length Of Hospital Stay ◽  
Adverse Outcomes ◽  
Neutrophil To Lymphocyte Ratio ◽  
Initial Time ◽  
Lymphocyte Ratio ◽  
Icu Admission ◽  
Marshall Score

Background: The management of Acute Pancreatitis (AP) is determined by an accurate assessment of severity of the disease. Numerous severity indicators have been described till date, most of which require reassessment after admission and resuscitation. We propose a novel indicator, the Neutrophil to Lymphocyte ratio (NLR), as a predictor of severity of acute pancreatitis at the initial time of diagnosis. NLR may have a role in predicting the length of hospital stay and ICU admission and also to predict adverse manifestations of Severe Acute Pancreatitis (SAP) including organ failure.Methods: A retrospective analysis was performed of 107 patients diagnosed with acute pancreatitis based on Atlanta 2012 definitions, who were admitted and treated between August 2017 and November 2017. The patients were grouped according to severity of acute pancreatitis and organ failure occurrence and a comparative analysis was performed to compare the NLR between groups. NLR was also compared with the modified Marshall score as a standard predictor of organ failure in acute pancreatitis.Results: Median NLR among the severe group is significantly higher compared to mild and moderate group (P <0.001). NLR significantly correlated with length of hospital stay (p 0.004) and also had a statistically significant correlation with ICU stay (p < 0.001). We found in our study that NLR at admission correlated significantly with the modified Marshall score in predicting the organ failure (p <0.001) in patients with acute pancreatitis. The receiver operator characteristic (ROC) curve analysis showed a cut-off values of NLR >8.5 at admission correlated with adverse outcomes in patients with acute pancreatitis.Conclusions: Neutrophil to Lymphocyte ratio (NLR) can be used as a predictor of severity of acute pancreatitis, right at the time of initial diagnosis. Further it may predict adverse outcomes, need for ICU care as well as length of hospital stay. NLR can be used as a tool to refer at risk patients to tertiary center needing ICU admission.

scholarly journals Clinical Profile and Outcome of Patients with Severe Acute Pancreatitis

2020 ◽  
Vol 9 (3) ◽  
pp. 8-11
Author(s):  
Rishabh Sehgal ◽  
Inder Pal Singh ◽  
Jyotisterna Mittal
Keyword(s):  
Acute Pancreatitis ◽  
Alcohol Consumption ◽  
Severe Acute Pancreatitis ◽  
Sofa Score ◽  
Clinical Profile ◽  
Etiological Factor ◽  
Clinical Severity ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Marshall Score

Background: Acute pancreatitis (AP) is an acute inflammatory condition of the pancreas leading to pancreatic autodigestion. The present study was conducted to study the clinical profile and outcome of patients with severe acute pancreatitis. Subjects & Methods: The study was conducted on 40 patients of acute pancreatitis. Clinical profile including history, examination findings, etiology of pancreatitis, clinical severity (according to Modified Marshall Score, BISAP score, APACHE II, HAPS score, SOFA score) was recorded. Results: Severe Acute Pancreatitis (SAP) among patients. Majority of the patients i.e. 22 (55%) had alcohol consumption as etiological factor causing SAP followed by biliary 10 (25%) & idiopathic 5 (12.5%). Hypertriglyceridemia and drug-induced (herbal medication) pancreatitis was present in 1 (2.5%) patient each. Out of all 1 (2.5%), patients had a history of both alcohol consumption and the presence of gallstone as an etiological factor. 22 patients (55%) out of 40 patients only conservative management was used while 18(45%) patients underwent USG guided percutaneous drainage was done. Out of these 18 patients, 3(7.5%) patients required Laparoscopic Necrosectomy & 2(5%) patients required open necrosectomy in addition to ultrasound-guided PCD. Patients who improved had a mean BISAP SCORE of 2.15   0.54, Modified Marshall score of 3.65    1.44, APACHE II score of 9.77  4.45, SOFA score 5.54  2.49, RANSON’s score 3.85   1.80 and HAP score of 0.65   0.63. Conclusion: Most common   etiology of severe acute pancreatitis is alcohol followed by biliary etiology. Out of severity scores (BISAP, APACHE-II, SOFA, HAPS), only BISAP score ≥3 is predictive of poor outcome in patients with severe acute pancreatitis.

scholarly journals APACHE II score, C-reactive protein and Marshall score in acute pancreatitis. Association with admission at critical care unit. A cohort study

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e321-e322
Author(s):  
H. Losada Morales ◽  
A. Troncoso Trujillo ◽  
L. Burgos San Juan ◽  
J. Silva Abarca ◽  
L. Acencio Barrientos ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Critical Care ◽  
Cohort Study ◽  
Critical Care Unit ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Marshall Score

scholarly journals Soluble B7-H5 Is a Novel Diagnostic, Severity, and Prognosis Marker in Acute Pancreatitis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ruoxin Xu ◽  
Ju Gong ◽  
Wei Chen ◽  
Yakang Jin ◽  
Jian Huang
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Severe Acute Pancreatitis ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Prognosis Marker ◽  
Score Apache ◽  
Marshall Score ◽  
Pain Patients ◽  
Ranson Score

As an important ligand in T lymphocyte costimulatory pathways, B7-H5 is involved deeply in the immune response in various diseases. However, its clinical usefulness as an early indicator in acute pancreatitis (AP) remains unclear. In this study, the levels of sB7-H5 and cytokines in plasma samples of 75 AP patients, 20 abdominal pain patients without AP, and 20 healthy volunteers were determined. Then, the correlation of sB7-H5 and clinical features, cytokines, the Ranson score, APACHE II score, Marshall score, and BISAP score was analysed, and the value of sB7-H5 for diagnostic, severity, and prognosis of AP was evaluated. We found that the levels of sB7-H5 were specifically upregulated in AP patients. Receiver operating characteristic (ROC) analysis revealed that sB7-H5 can identify AP patients from healthy or abdominal pain patients with 78.9% or 86.4% sensitivity and 93.3% or 90.0% specificity. Further analysis showed that the levels of sB7-H5 were significantly correlated with WBC ( p = 0.004 ), GLU ( p = 0.008 ), LDH ( p < 0.001 ), Ca2+ ( p = 0.006 ), AST ( p = 0.009 ), PLT ( p = 0.041 ), IL-6 ( p < 0.001 ), IL-10 ( p < 0.001 ), and TNF-α ( p < 0.001 ). And levels of sB7-H5 were gradually increased among patients with mildly acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP). It can distinguish the severity of AP with good sensitivity and specificity. Moreover, when dividing the patients into two groups according to the median level of sB7-H5, the local complication and length of stay of low levels of the sB7-H5 group were significantly less than those in high levels of the sB7-H5 group. And the levels of sB7-H5 in AP patients were significantly correlated with the Ranson score ( p < 0.001 ), APACHE II score ( p < 0.001 ), Marshall score ( p < 0.001 ), and BISAP score ( p < 0.001 ). The AUCs of assessing local complications of sB7-H5 at day 1 and day 3 were 0.704 ( p = 0.0024 ) and 0.727 ( p = 0.0373 ). These results showed the potential value of sB7-H5 as a diagnostic, severity, and prognosis marker of AP.

Mo1341 D -Dimer in Acute Pancreatitis -A New Approach for an Early Assessment of Severity, Necrosis, Organ Failure and Mortality in Acute Pancreatitis

2014 ◽  
Vol 146 (5) ◽  
pp. S-624
Author(s):  
Sreekanth Appasani ◽  
Jahangeer B. Medarapalem ◽  
Neelam Varma ◽  
Jasmina Ahluwalia ◽  
Thakur D. Yadav ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Early Assessment ◽  
New Approach ◽  
D Dimer

Dimethyl-trisulfide: new approach to ameliorate experimental acute pancreatitis

Pancreatology ◽  
2019 ◽  
Vol 19 ◽  
pp. S103
Author(s):  
Eszter Kormányos ◽  
Gabriella Für ◽  
Ahmad Totunji ◽  
Zsolt Balla ◽  
Emese Réka Bálint ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Experimental Acute Pancreatitis ◽  
New Approach ◽  
Dimethyl Trisulfide

scholarly journals Thoracic epidural analgesia: a new approach for the treatment of acute pancreatitis?

Critical Care ◽  
2016 ◽  
Vol 20 (1) ◽  
Author(s):  
Olivier Windisch ◽  
Claudia-Paula Heidegger ◽  
Raphaël Giraud ◽  
Philippe Morel ◽  
Léo Bühler
Keyword(s):  
Acute Pancreatitis ◽  
Epidural Analgesia ◽  
Thoracic Epidural Analgesia ◽  
New Approach ◽  
Thoracic Epidural

scholarly journals The prognostic value of neutrophil-lymphocyte ratio in acute pancreatitis

2016 ◽  
Vol 18 (3) ◽  
pp. 27
Author(s):  
Binit Katuwal ◽  
Sushil Kumar Shilpakar
Keyword(s):  
Acute Pancreatitis ◽  
University Teaching ◽  
Total Leucocyte Count ◽  
P Value ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Surgical Ward ◽  
The Mean ◽  
Marshall Score ◽  
One Year

Introduction and objective: Acute Pancreatitis (AP) is one of the leading causes of morbidity and mortality worldwide. In approximately a third of the patient with acute pancreatitis, severe pancreatitis may develop, producing progressive organ dysfunction caused by a systemic inflammatory response syndrome (SIRS). This study aimed to determine the correlation between Neutrophil Lymphocyte Ratio (NLR) and the severity of AP.Materials and Methods: All patients admitted in the Surgical Ward of Tribhuvan University Teaching Hospital with the diagnosis of AP were studied prospectively over a period of one year from January 2014 to January 2015. Total leucocyte count (TLC), neutrophil count, lymphocyte count and neutrophil lymphocyte ratio (NLR) at admission was recorded for each patient. Modified Marshall Score was determined at admission and at 48 hours. Severity of acute pancreatitis as defined by revised Atlanta Classification 2012 was taken into account.Results: A total of 79 patients of AP were included in the study. Among them, 38 % were categorized as having severe AP according to the revised Atlanta classification. There was a weak positive correlation of NLR to severity of AP which was statistically significant. The mean NLR was high in higher severity grades of AP (p-value < 0.05). The cutoff NLR of 8.02 showed sensitivity of 60 %, specificity of 60.4 %, PPV of 48.6 % and NPV of 70.7 %.Conclusion: NLR may be useful as an easy and reliable prognostic marker for the severity and complications of acute pancreatitis.

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