Acute Pancreatitis in the Upper Age Groups

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

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Prevalence, morbidity and mortality of hypertriglyceridemic acute pancreatitis in the General Hospital of Playa del Carmen, México. Analysis of five years

10.36811/ijcgh.2019.110001 ◽

2019 ◽

pp. 01-06

Author(s):

Argel de Jesús Concha May ◽

Guillermo Padrón Arredondo

Keyword(s):

Diabetes Mellitus ◽

Acute Pancreatitis ◽

Age Groups ◽

Morbidity And Mortality ◽

Cross Sectional ◽

History Of ◽

Hospital Stays ◽

Clinical Conditions

Introduction: Hypertriglyceridemia (HTG) is the underlying cause of pancreatitis in 7% of the general population and is the third cause after gallstones and alcohol. HTG may be associated with acute pancreatitis as an epiphenomenon or as a precipitant thereof. Generally, more than 75% of pancreatitis induced by hypertriglyceridemia is due to secondary causes and although these are not sufficient to elevate triglycerides to cause pancreatitis, a preexisting defect is required to obtain a TG>1000 mg/dL to induce acute pancreatitis. Material and Method: To identify the prevalence morbidity and mortality of acute pancreatitis due to hypertriglyceridemia, a retrospective and cross-sectional observational clinical study was performed for a period of five years. Results: During the study period, 100 cases of acute pancreatitis of various etiologies were collected, 29 (29%) of which corresponded to acute pancreatitis of hypertriglyceridemic origin; history of risk: type 1 Diabetes mellitus one case (3.4%); Type 2 Diabetes mellitus 27 cases (24%); history of alcoholism nine cases (31%); positive smoking 4 cases (13.8%); hypertriglyceridemia 27 cases (94%); obesity 17 cases (59%); lipemic serum 19 cases (65.5%), and In-hospital stays average six days. Mortality in one case. Discussion: In the Mexican national survey of ENASUT 2012, it was found by age group that hypercholesterolemia is highest in the age groups of 50-69 years of age. (Table 1) The frequency of hyperlipidemia in patients with pancreatitis ranges from 12 to 38%, and of hypertriglyceridemia, between 4 and 53%; what is important is to define whether its presence is primary or causal, or secondary or consequence of other clinical conditions such as Diabetes mellitus, alcohol abuse, pregnancy or use of medications. The triglycerides were obtained on routine laboratory tests in our hospital and their values were steadily elevated and the hipertrigliceridemic acute pancreatitis is the principal cause instead the alcoholic acute pancreatitis. Keywords: Pancreatitis acute;Hypertriglyceridemic; Prevalence; Morbidity; Mortality

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Retrospective Evaluation of Elderly and Young Patients with Acute Pancreatitis

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v7i01.04 ◽

2020 ◽

Vol 7 (01) ◽

pp. 4691-4694

Author(s):

Hatice Beyazal Polat ◽

Teslime Ayaz ◽

Hüseyin Duru ◽

Adnan Remzi Akdoğan ◽

Mehmet Beyazal ◽

...

Keyword(s):

Acute Pancreatitis ◽

Disease Severity ◽

Age Groups ◽

Young Patients ◽

Scoring Systems ◽

Demographic Characteristics ◽

Morbidity And Mortality ◽

Additional Risk Factor ◽

Laboratory Findings ◽

Hospitalization Period

Background/aim: Acute pancreatitis (AP) is a clinical situation that should be included in the differential diagnosis of patients presenting with complaints of abdominal pain, nausea, and vomiting. The aim of this study is to investigate the in-hospital morbidity and mortality of patients with acute pancreatitis at our clinic. Materials and Methods: In total, 159 patients with acute pancreatitis were included in the study and analyzed retrospectively. Patients were divided into two groups: those over 65 years old and those younger than 65 years. The demographic characteristics, severity, treatment, patient prognoses,and hospitalization duration were recorded. The relationship between APseverity, etiological factors, age, gender, length of stay, and prognosis was investigated for both groups. Results: Acute biliary pancreatitis was detected in 99 (62.3) of the 159 patients. Biliary causes were significantly higher among the elderly group. There was no relationship between disease severity and demographic characteristics or clinical and laboratory findings. When the hospitalization period was compared between age groups, the hospitalization period for the group over 65 years was found to be significantly longer than that of the other group. The mortality rate was 0% in the group younger than 65 years and 3.2% in the group older than 65 years (three patients). This rate was not statistically significant due to the low incidence of death. Conclusion: Gallstonesis a leading cause in the etiology of AP. Prognostic scoring systems should be used to determine the disease severity and age should be considered an additional risk factor in the increased morbidity and mortality of AP.

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STUDY OF ALBUMIN, CALCIUM AND ALBUMIN CORRECTED CALCIUM WITH SEVERITY OF ACUTE PANCREATITIS

10.36106/gjra/6100983 ◽

2021 ◽

pp. 23-25

Author(s):

Meghna Sharma ◽

Bushra Fiza ◽

Pragati Upadhyay ◽

Arun Kumar ◽

Maheep Sinha

Keyword(s):

Acute Pancreatitis ◽

Age Groups ◽

Lactating Women ◽

Medical College ◽

History Of ◽

Independent Risk Factors ◽

The Mean ◽

Reliable Marker ◽

Gandhi Medical College ◽

Mild Acute Pancreatitis

Aim: The purpose of this study to evaluate the level of serum Albumin, Calcium and Albumin corrected calcium with severity of acute pancreatitis. Material and methods:The study was conducted in Department of Biochemistry in association with Department of Gastroenterology, Mahatma Gandhi Medical College & Hospital. In present study out of 133 patients diagnosed for Acute Pancreatitis; total 115 patients (n=115) of either gender of 18 to 65years age groups were enrolled for the study. Patients with history of any acute or chronic illness like: - Hyperparathyroidism, Diabetes Mellitus, Impaired renal function, Malnourished, Pregnant and lactating women and patients on calcium supplements were excluded. Result: Mean level of calcium decreased with progression in disease severity (p≤0.001).The mean Albumin Corrected Calcium was also signicantly lower in the patients presenting with severe and moderate acute pancreatitis compared with the mild acute pancreatitis patients (p≤0.0001). Conclusion: The study recommends hypocalcaemia and hypoalbuminemia as independent risk factors of progression towards severe pancreatitis. Similarly, albumin corrected calcium is suggested as a reliable marker for severity of pancreatitis.

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TO STUDY THE INCIDENCE, ETIOLOGY AND CORRELATION BETWEEN SERUM AMYLASE LEVELS AND BALTHAZAR SCORE (SEVERITY) IN PATIENTS OF ACUTE PANCREATITIS AT TERTIARY CARE HOSPITAL

10.36106/ijsr/1636450 ◽

2020 ◽

pp. 1-3

Author(s):

Snehal N. Purandare ◽

Aishwarya U. Chavan ◽

Brijesh U. Patil

Keyword(s):

Acute Pancreatitis ◽

Serum Amylase ◽

Age Groups ◽

Care Hospital ◽

Normal Range ◽

Female Ratio ◽

Common Cause ◽

Presenting Symptoms ◽

Number Of Patients ◽

The Mean

Acute pancreatitis is a heterogeneous disease ranging from minimal pancreatic inflammation seen in mild interstitial pancreatitis to extensive pancreatic necrosis and liquefaction of severe attacks. The incidence of acute pancreatitis is 33.3 per 100,000 population. Maximum number of patients with acute pancreatitis belong to the age groups of 26 – 35 years and 36- 45 years with 34.8% of cases in each of the mentioned age groups. The mean age of presentation was 39 years. Out of the 89 patients who were diagnosed with pancreatitis, only 5 patients were females while all others were males. The male to female ratio was 16.8: 1 with male preponderance. On presentation, all 89 patients (100%) had pain in abdomen, 89.9% of the cases had vomiting and 64% of the cases had radiating back pain as the presenting symptoms. Alcohol abuse was found to be the most common cause of pancreatitis isolated in 89.9% of the patients which explains the 16.8:1 male female ratio. The second most common cause was gallstone induced pancreatitis (9%) while idiopathic pancreatitis was found in 1.1% of the cases. None of the patients had other rare causes of pancreatitis amongst the miscellaneous category. The sensitivity of serum amylase was 84.3% while the specificity of serum amylase was 55.9%. For Balthazar score (inflammation) 1, 2, 3 the mean serum amylase value (U/L) was 696.5, 829.6 and 822.0 respectively. [Normal Range: 22 – 80U/L in our institute] For Balthazar score (necrosis) 0, 2, 4 the mean serum amylase value (U/L) was 738.1, 57.7 and 43 respectively. [Normal Range: 22 – 80U/L in our institute] As the Balthazar score (necrosis) increases, the value of serum amylase remains in the normal limits and does not increase suggesting an inverse correlation between the two.

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Clinical features of acute pancreatitis in people of different age groups: A retrospective analysis

World Chinese Journal of Digestology ◽

10.11569/wcjd.v27.i10.624 ◽

2019 ◽

Vol 27 (10) ◽

pp. 624-631

Author(s):

Hui-Fen Wei ◽

Guo-Du Tang ◽

Zhi-Hai Liang ◽

Meng-Bin Qin ◽

Hui-Ying Yang ◽

...

Keyword(s):

Acute Pancreatitis ◽

Retrospective Analysis ◽

Clinical Features ◽

Age Groups

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Role of total calcium and corrected calcium in comparisons with computed tomography to predict severity of acute pancreatitis

International Surgery Journal ◽

10.18203/2349-2902.isj20200286 ◽

2020 ◽

Vol 7 (2) ◽

pp. 399

Author(s):

Anjali Thakur ◽

Gitanjali Goyal ◽

Simmi Aggarwal ◽

Sarabjeet Singh

Keyword(s):

Computed Tomography ◽

Acute Pancreatitis ◽

Predictive Value ◽

Age Groups ◽

Severity Index ◽

Significant Negative Correlation ◽

Medical College ◽

R Value ◽

Rule Out

Background: The objective of the study was to evaluate corrected calcium levels in patient of acute pancreatitis and to evaluate role of corrected calcium as predictor of severity in acute pancreatitis in comparison to computed tomography (CT) scan.Methods: The study was conducted in Department of Biochemistry of G.G.S Medical College in collaboration with the Department of Surgery and Department of Radio diagnosis. 50 patients, with clinical diagnosis of acute pancreatitis, attending the Inpatient Department of Department of Surgery, were taken. 50 patients, of either sex of 18 to 70 age groups suffering from acute pancreatitis were enrolled for the study.Results: On exploring the data, highly significant negative correlation found between CT severity index (CTSI) and serum calcium (p≤0.001; r value=-0.520) whereas the non-significant correlation found between CTSI and amylase (p=0.778; r value=-0.041). The corrected calcium and CTSI shows highly negative significant correlation (p≤0.001; r value=-0.654). Serum albumin with CTSI also shows significant correlation (p=0.006; r value=0.385). But no significant association with lipase (p≥0.05).Conclusions: We observed that corrected calcium and calcium is better and alternative marker for predicating the severity of disease because corrected calcium and calcium is having good positive predictive value to indicate progression of damage and also a highly significant negative predictive value to rule out severity of acute pancreatitis.

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STUDY OF IMPAIRED GLUCOSE TOLERANCE AND HBA1C IN ACUTE PANCREATITIS ON THE BASIS OF SEVERITY

10.36106/ijsr/5302607 ◽

2021 ◽

pp. 83-85

Author(s):

Meghna Sharma ◽

Bushra Fiza ◽

Pragati Upadhyay ◽

Arun Kumar ◽

Maheep Sinha

Keyword(s):

Acute Pancreatitis ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Impaired Renal Function ◽

Age Groups ◽

Lactating Women ◽

Calcium Supplements ◽

Severe Pancreatitis ◽

History Of ◽

Hba1c Levels

Aim:The study was planned to evaluate the association of Impaired Glucose Tolerance and HbA1c with severity of acute pancreatitis. Material and methods: In present study Out of 133 patients diagnosed for Acute Pancreatitis; total 115 patients (n=115), of either gender of 18 to 65 years age groups were enrolled for the study. Patients with history of any acute or chronic illness like:-Diabetes Mellitus Impaired renal function, Hyperparathyroidism, Malnourished, Pregnant and lactating women and patients on calcium supplements were excluded. Result: The % of patients with impaired glucose tolerance was higher in patients suffering from severe pancreatitis. A signicant association was observed between impaired glucose tolerance and severity of pancreatitis (p ≤ 0.0001).Also signicant difference was observed in the HbA1c levels among three groups [mild, moderate and severe AP (p≤0.0001)]. Conclusion: The study concluded that a higher % of patients of severe pancreatitis group were diabetic or at risk of developing diabetes as compared to mild pancreatitis group.

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RISK FACTORS ASSOCIATED WITH WORSENING OF ACUTE PANCREATITIS.

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v5i1.742 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Neeraj Dhar ◽

Syed Mushfiq Shafi ◽

Jaswinder Singh ◽

G.M. Gulzar ◽

Altaf Hussain Shah ◽

...

Keyword(s):

Risk Factors ◽

Acute Pancreatitis ◽

Waist Circumference ◽

Blood Sugar ◽

Clinical Laboratory ◽

Age Groups ◽

Significant Risk ◽

High Blood Sugar ◽

Severe Pancreatitis ◽

Mild Acute Pancreatitis

Background: The aim of the present study was to investigate risk factors for developing more severe pancreatitis, including moderately severe (MSAP) and severe acute pancreatitis (SAP), in patients admitted with mild acute pancreatitis (MAP). Material/Methods: This was a hospital based retrospective and prospective study conducted in the Department of Gastroentrology, SKIMS Soura,Srinagar, Kashmir for a period of 2 years w.e.f. September 2017 to September 2019 on patients of all age groups with clinical/Laboratory/imaging findings suggestive of acute pancreatitis. The protocol of the study was approved by the Institutional Ethical Committee. Patients admitted with MAP to our hospital were included and prospectively evaluated. Possible risk factors for developing MSAP or SAP were Evaluated. Results: Risk factors like BMI >25kg/m2 was observed in 61 (19.3%) patients with mild pancreatitis and 142 (42.5%) patients with moderate to severe pancreatitis. Waist circumference >100cm was observed in 23 (7.3%) and 129 (38.6%) patients of mild and moderate to severe pancreatitis. High blood sugar >200mg/dl was observed in 37 (11.7%) patients with mild pancreatitis and 152 (45.2%) patients with moderate to severe pancreatitis. 27 (8.5%) and 167 (50%) patients of mild and moderate to severe pancreatitis had hematocrit >44 whereas 13 (4.1%) patients with mild pancreatitis and 140 (41.9%) patients with moderate to severe pancreatitis had CRP >150mg/dl. This table concluded that there is statistically significant association between high BMI >25 Kg/m2, waist circumference >100 cm, high blood sugar >200 mg /dl, hematocrit >44, CRP >150 mg/d and worsening of AP. Conclusions: Significant risk factors for developing MSAP or SAP in patients admitted with MAP included BMI (≥25 kg/m2), APACHE-II (≥5), and blood glucose level on admission (>11.1 mmol/L). These factors should be used in the prediction of more severe pancreatitis in patients admitted with MAP. Keywords: Obesity, Pancreatitis, Risk Factors

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