scholarly journals A prospective study to predict the severity of acute pancreatitis by BISAP score

2017 ◽  
Vol 4 (7) ◽  
pp. 2221
Author(s):  
Yogesh Kumar Bung ◽  
Chandrasekhar Sharanappa Neeralagi ◽  
Lakkanna Suggaiah ◽  
Usharani Rathnam ◽  
Chandrakant Kesari
Keyword(s):  
Acute Pancreatitis ◽  
Mortality Rate ◽  
Prospective Study ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Medical Science ◽  
Fisher Exact Test ◽  
Local Complications ◽  
Increased Risk ◽  
A Prospective Study

Background: Acute pancreatitis (AP) is as an inflammation of the pancreas with varied range of complication like peri-pancreatic collection, pancreatic necrosis, renal failure, multi-organ dysfunction syndrome which increases mortality rate and morbidity. Majority of AP cases are mild but severe cases of AP are associated with increased complication and mortality. BISAP is simple bedside prognostic scoring system for predicting severity of AP. BISAP is a collection of simple routine investigation and scores are quantified at 24hours of onset of AP. This study aims to assess prognosis of AP cases at ESIC Medical college and Post Graduate Institute of Medical Science and Research, Bangalore, Karnataka, India.Methods: A prospective study of 60 Patients who were diagnosed as AP according to RAC. All patients were admitted in high dependency unit with close observation of vital parameters and investigations were done at 24 hours of onset of AP. BISAP score >3 was considered as Severe Acute Pancreatitis, its correlation with local complications, organ failure, ICU stay and Mortality was studied. Statistical analysis done using Chi-square test and Fisher Exact test for local complications and organ failure using xL Stat and SPSS v.21.0, a p-value <0.05 was considered to be significant.Results: Of the 60 patients, BISAP score was >3 and <3 in 15 and 45 patients respectively. Alcohol was the most common cause of acute pancreatitis, accounting for 53.33%. In current study 12 (20%) patients developed organ failure and among them 9 (75%) had transient organ failure and 3 (25%) had persistent organ failure. Total 8 (13%) patients had developed pancreatic necrosis and among them 6 had BISAP >3. Mortality rate in this study was 2%.Conclusions: The BISAP score is a simple and fairly accurate method for the early identification of patients at increased risk for in hospital mortality and to identify patients at risk of the development of intermediate markers of severity and organ failure within 24 hours of presentation.

scholarly journals A prospective study of BISAP score in assessing severity of acute pancreatitis

2018 ◽  
Vol 5 (5) ◽  
pp. 1785
Author(s):  
Mahidhar Reddy Venkatapuram ◽  
Sreeram Sateesh ◽  
Deepthi Batchu
Keyword(s):  
Acute Pancreatitis ◽  
Prospective Study ◽  
Organ Failure ◽  
Scoring System ◽  
Pancreatic Necrosis ◽  
Statistical Analyses ◽  
Exact Probability ◽  
Patients At Risk ◽  
The Difference ◽  
A Prospective Study

Background: Aim of study is to prospectively evaluate the ability of the Bedside Index for Severity in Acute Pancreatitis (BISAP) score to predict mortality as well as intermediate markers of severity.Methods: 50 patients admitted from December 2015 to November 2017 with acute pancreatitis were included in the study. BISAP score is calculated in all such patients based on data obtained within 24hrs of hospitalization. Patients were assessed for organ failure according to Marshall scoring system and followed throughout hospitalization for assessment of complications. Statistical analyses were made using Fischer’s exact probability test. The difference was assumed statistically significant when p<0.05.Results: There was a statistically highly significant trend for increasing mortality (p < 0.05) and intermediate markers of severity (p<0.05) that is transient organ failure, persistent organ failure and pancreatic necrosis with BISAP score ≥3.Conclusions: The BISAP score represents a simple way to identify patients at risk of increased mortality and the development of intermediate markers of severity within 24 hours of presentation.

scholarly journals SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323364
Author(s):  
Sanjay Pandanaboyana ◽  
John Moir ◽  
John S Leeds ◽  
Kofi Oppong ◽  
Aditya Kanwar ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Stay ◽  
Organ Failure ◽  
Collaborative Study ◽  
Length Of Hospital Stay ◽  
Secondary Outcome ◽  
Icu Admission ◽  
Local Complications ◽  
Persistent Organ Failure ◽  
Increased Risk

ObjectiveThere is emerging evidence that the pancreas may be a target organ of SARS-CoV-2 infection. This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and coexistent SARS-CoV-2 infection.DesignA prospective international multicentre cohort study including consecutive patients admitted with AP during the current pandemic was undertaken. Primary outcome measure was severity of AP. Secondary outcome measures were aetiology of AP, intensive care unit (ICU) admission, length of hospital stay, local complications, acute respiratory distress syndrome (ARDS), persistent organ failure and 30-day mortality. Multilevel logistic regression was used to compare the two groups.Results1777 patients with AP were included during the study period from 1 March to 23 July 2020. 149 patients (8.3%) had concomitant SARS-CoV-2 infection. Overall, SARS-CoV-2-positive patients were older male patients and more likely to develop severe AP and ARDS (p<0.001). Unadjusted analysis showed that SARS-CoV-2-positive patients with AP were more likely to require ICU admission (OR 5.21, p<0.001), local complications (OR 2.91, p<0.001), persistent organ failure (OR 7.32, p<0.001), prolonged hospital stay (OR 1.89, p<0.001) and a higher 30-day mortality (OR 6.56, p<0.001). Adjusted analysis showed length of stay (OR 1.32, p<0.001), persistent organ failure (OR 2.77, p<0.003) and 30-day mortality (OR 2.41, p<0.04) were significantly higher in SARS-CoV-2 co-infection.ConclusionPatients with AP and coexistent SARS-CoV-2 infection are at increased risk of severe AP, worse clinical outcomes, prolonged length of hospital stay and high 30-day mortality.

scholarly journals Computed Tomography Evaluation of Acute Pancreatitis and Its Complications – A Prospective Study at a Tertiary Referral Center

2021 ◽  
Vol 8 (11) ◽  
pp. 643-647
Author(s):  
Rama Krishna Narra ◽  
Manjeera Boddepalli ◽  
Narasimhachary Munjuwanpalli ◽  
Bhimeswarao Pasupaleti
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Prospective Study ◽  
Pancreatic Necrosis ◽  
Contrast Enhanced ◽  
Necrotising Pancreatitis ◽  
Enhanced Computed Tomography ◽  
A Prospective Study ◽  
Contrast Enhanced Computed Tomography ◽  
Score Index

BACKGROUND Acute pancreatitis (AP) is described as acute inflammation of the pancreas with or without peripancreatic abnormalities. The present study describes the role of computed tomography in the evaluation and grading of acute pancreatitis. Acute pancreatitis is a dynamic disease having biphasic mortality peaks due to two overlapping phases, which include early and late due to increased obesity, ageing of population, alcohol abuse, increased gall stone incidence, the worldwide AP incidence is increasing. Most important causes of AP in developing countries such as India include increased alcohol consumption. Contrast enhanced computed tomography plays an important role in diagnosis of the disease and helps in determining the prognosis of the disease. Modified CT severity index scoring system is the most commonly used scoring system for assessment of the severity of the disease. METHODS The present study is a prospective study of patients presenting with signs and symptoms of acute pancreatitis referred to the Department of Radio Diagnosis at Katuri medical college. This study comprised of 50 patients with clinical suspicion / diagnosis of acute pancreatitis, raised pancreatic biochemical parameters like serum amylase and serum lipase. Contrast enhanced computed tomography was performed in these patients, findings reported, and the disease was classified using modified CT scoring index system (MCTSI). RESULTS The mean age of the patients in the present study was 42.3 ± 12.28 years. Most of the patients presented with abdominal epigastric pain, abdominal distension. Acute pancreatitis was divided into acute oedematous pancreatitis and necrotising pancreatitis, the former being common. Complications included, ascites, pleural effusions, splenic vein thrombosis, portal venous thrombosis, and haemorrhages. CONCLUSIONS Contrast enhanced CT is useful to differentiate between oedematous and necrotising types of pancreatitis. The MCTSI helps in better evaluation of pancreatic necrosis grading. The modified computed tomography score index correlation with the development of local and systemic complications in acute pancreatitis is well established. Ideally, conducting contrast enhanced computed tomography (CECT) after 48 - 72 hours of acute attack, increases the probability of identifying necrotising pancreatitis. CT in particular has an overall accuracy of about 87 % and sensitivity and specificity of 100 % in the recognition of pancreatic necrosis. KEYWORDS Computed Tomography, Acute Pancreatitis, Pseudocyst, Modified CT Score Index

scholarly journals Intravenous fluids in acute pancreatitis: a prospective study

2020 ◽  
Vol 7 (10) ◽  
pp. 3365
Author(s):  
Jithin Sony ◽  
Ann Sunny ◽  
Anthony Prakash Rozaria
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Fluid Therapy ◽  
Prospective Observational Study ◽  
High Volume ◽  
Local Complications ◽  
Significant Difference ◽  
Randomised Control Trials ◽  
Volume Group ◽  
A Prospective Study

Background: Fluid therapy is the mainstay of treatment in the management of acute pancreatitis. Most guidelines recommend aggressive fluid therapy in the initial 48-72 hours. We aimed to compare the occurrence, persistence or worsening of systemic inflammatory response syndrome (SIRS) and occurrence organ failure in patients with acute pancreatitis receiving normal and high volume fluid therapy in the first 24 hours.Methods: This was a prospective observational study. Consecutive adult patients admitted with acute pancreatitis were included in the study. SIRS was defined according to the criteria. Organ failure and local complications were defined according to Atlanta classification. Patients were divided into two groups according to the rate of fluid administered in the initial 24 hours: Normal volume group which received fluids at a rate <150 ml/hour and high volume group >150 ml/hour.Results: A total 60 patients were included in the study with 30 each in the two groups. Persistence or worsening of SIRS at 48 hours was more in normal volume fluid group compared to the high volume fluid group (p=0.076). Organ failure at 48 hours was more in normal volume fluid group compared to the high volume fluid group (p=0.074). Incidence of local complications equal in both group.Conclusions: Our study did not show any statistically significant difference in outcomes in patients with acute pancreatitis receiving normal or high volume fluids in the initial 24 hours. Further multi-centric randomised control trials are required to analyze the outcomes of high and normal volume fluid resuscitation in acute pancreatitis.

scholarly journals Haematological abnormalities in acute pancreatitis. A prospective study.

1977 ◽  
Vol 53 (620) ◽  
pp. 310-314 ◽  
Author(s):  
D. Murphy ◽  
C. W. Imrie ◽  
J. F. Davidson
Keyword(s):  
Acute Pancreatitis ◽  
Prospective Study ◽  
A Prospective Study

scholarly journals Bridge-therapy with enoxaparin in the preoperative period of endarterectomy

2010 ◽  
Vol 68 (5) ◽  
pp. 775-777
Author(s):  
Jair Leopoldo Raso ◽  
Rogério Zenóbio Darwich ◽  
Francisco de Lucca Jr ◽  
Romeu Valle Santana ◽  
Marco Túlio Tanure ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Mortality Rate ◽  
Prospective Study ◽  
Low Molecular Weight Heparin ◽  
The Other ◽  
Low Molecular Weight ◽  
Preoperative Period ◽  
Safe Strategy ◽  
A Prospective Study ◽  
Bridge Therapy

Cervical clot is one of the complications of endarterectomy. This risk may be higher in patients using aspirin or clopidogrel. On the other hand, stroke may occur if the medication is interrupted before surgery. We carried out a prospective study of 124 endarterectomies in 119 patients in which aspirin or clopidogrel was stopped and a bridge-therapy with enoxaparin was administered preoperatively. There was no case of stroke during the period of the bridge-therapy. One patient developed cervical clot (0.8%) in the fifth postoperative day. Mortality rate in this series was 0.8%. There was no complication directly related to the use of enoxaparin. Bridge-therapy with low molecular weight heparin is a safe strategy for patients elected for endarterectomy

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