scholarly journals Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis

2017 ◽  
Vol 7 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Dina Zerem ◽  
Omar Zerema ◽  
Enver Zerem
Keyword(s):  
Acute Pancreatitis ◽  
Leukocyte Count ◽  
Apache Ii ◽  
Close Monitoring ◽  
Early Assessment ◽  
Diagnostic Parameters ◽  
Factors Associated ◽  
Imaging Parameters ◽  
Glasgow Score

ABSTRACT Aim The assessment of the severity of acute pancreatitis (AP) is important for proper management of the disease and for its prognosis. The aim was to correlate clinical, biochemical, and imaging diagnostic parameters and evaluate their prognostic values in the early assessment of severity of AP. Materials and methods We prospectively studied 128 consecutive patients with AP. The predictors were clinical, biochemical, and imaging diagnostic parameters. The outcome measure was the occurrence of complications. Abdominal sonogram, contrast-enhanced computer tomography, and pancreatitis-specific clinical and laboratory findings were done. Results According to the Atlanta classification, 84 patients (65.6%) had mild and 44 (34.4%) had severe AP. The severity markers were significantly different between the mild and the severe groups (p < 0.001). Leukocyte count, serum albumin level, C-reactive protein (CRP), Ranson, acute physiology and chronic health evaluation II (APACHE II), and Glasgow score were the factors associated with radiological severity grade. Leukocyte count, CRP, Ranson score, APACHE II, and Glasgow score were the factors associated with the number and appearance of acute fluid collections (AFCs). A significant association was found between the number of AFCs and the occurrence of complications [odds ratio 4.4; 95% confidence interval 2.5–7.6]. Hospital stay was significantly longer in the group with severe disease as compared with the group with mild disease (p < 0.001). Conclusion Clinical, biochemical, and imaging diagnostic parameters are related to the clinical course of AP and they can predict its severity. This allows us to determine the severity of the disease and to target the patients with high scores for close monitoring and more aggressive intervention. How to cite this article Zerem D, Zerem O, Zerem E. Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis. Euroasian J Hepato-Gastroenterol 2017;7(1):1-5.

Role of Intra-Abdominal Pressure as a Prognostic Marker and Its Correlation with APACHE II and SOFA Scores in Patients of Acute Pancreatitis

2021 ◽  
Author(s):  
Arun Kumar Gupta ◽  
Ekta Yadav ◽  
Nikhil Gupta ◽  
Raghav Yelamanchi ◽  
Lalit Kumar Bansal ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Prognostic Marker ◽  
Apache Ii ◽  
Abdominal Pressure

Advantages of Modified Computed Tomography Severity Index of Acute Pancreatitis Over Other Scoring System

KYAMC Journal ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 110-113
Author(s):  
Md Mofazzal Sharif ◽  
Khaleda Parvin Rekha ◽  
Umme Iffat Siddiqua ◽  
Mst Monira Khatun ◽  
AKM Enamul Haque ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Clinical Outcome ◽  
Severe Disease ◽  
Severity Index ◽  
Observer Variation ◽  
Imaging Method ◽  
Close Monitoring ◽  
Early Assessment ◽  
Prompt Treatment

Pancreatitis is one of most complex and clinically challenging of all abdominal disorders. USG and abdominal Computed Tomography (CT) are the most commonly used diagnostic imaging modalities for the evaluation of pancreas. Computed Tomography (CT) is highly accurate and sensitive than USG in both diagnosing as well as demonstrating the extent. Early assessment of the cause and severity of acute pancreatitis is of utmost importance for prompt treatment and close monitoring of patient with severe disease. CT is the imaging method of choice for assessing the extent of acute pancreatitis and for evaluating complications. CT severity index is used to assess prognostic correlation and clinical outcome of acute pancreatitis. Modified CT severity index makes the score easier to calculate and reduces the inter-observer variation. KYAMC Journal Vol. 10, No.-2, July 2019, Page 110-113

scholarly journals Factors associated with mortality of patients with myxoedema coma: prospective study in 11 cases treated in a single institution

2004 ◽  
Vol 180 (2) ◽  
pp. 347-350 ◽  
Author(s):  
I Rodriguez ◽  
E Fluiters ◽  
LF Perez-Mendez ◽  
R Luna ◽  
C Paramo ◽  
...  
Keyword(s):  
Mortality Rates ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Single Institution ◽  
Mean Values ◽  
Serum Free ◽  
Factors Associated ◽  
The Mean ◽  
Main Factors ◽  
Glasgow Score

This study was carried out to investigate the clinical and biochemical factors which might be of importance in predicting the outcome of patients with myxoedema coma. Eleven patients (ten female) aged 68.1+/-19.5 years attended our institution over a period of 18 years.Glasgow and APACHE II scores and serum free thyroxine and TSH were measured in all the patients on entry. Patients were selected at random to be treated with two different regimens of l-thyroxine.Four patients died with the mortality rate being 36.4%. The patients in coma at entry had significantly higher mortality rates than those with minor degrees of consciousness (75% vs 14.3% respectively, P=0.04). The surviving patients had significantly higher Glasgow scores than those who died (11.85+/-2.3 vs 5.25+/-2.2 respectively, P<0.001). Comparison of the mean values of APACHE II scores between the surviving group and those who died was significantly different (18.0+/-2.08 vs 31.5+/-2.08 respectively, P<0.0001).The degree of consciousness, the Glasgow score and the severity of the illness measured by APACHE II score on entry were the main factors that determined the post-treatment outcome of patients with myxoedema coma.

scholarly journals The Perfect Way to Predict the Severity of Acute Pancreatitis: The Search Continues

2004 ◽  
Vol 18 (6) ◽  
pp. 409-410
Author(s):  
Daniel C Sadowski
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Utility ◽  
Rating Scales ◽  
Surgical Intervention ◽  
Apache Ii ◽  
Severe Pancreatitis ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Glasgow Score

This study was designed to determine the clinical utility of three rating scales (Ranson's, Acute Physiology And Chronic Health Evaluation [APACHE] II and Glasgow) in predicting the severity of acute pancreatitis experienced by patients known to have human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). A retrospective analysis identified 73 patients with both acute pancreatitis and HIV who had been admitted to two Canadian hospitals between 1989 and 1999. Of those 73, 11 (15%) went on to have a clinical course consistent with a diagnosis of severe pancreatitis. For the purposes of the study, severe pancreatitis was defined by the occurrence of death, intensive care unit admission, surgical intervention or significant symptomatic local complications (necrosis, abscess or pseudocyst). The authors found that the APACHE II and Ranson's scores had a sensitivity of 100% and specificities of 70% and 33% for severe pancreatitis, respectively. The Glasgow score had a statistically poorer diagnostic performance.

scholarly journals Procalcitonin and BISAP score versus c-reactive protein and APACHE II score in early assessment of severity and outcome of acute pancreatitis

2012 ◽  
Vol 69 (5) ◽  
pp. 425-431 ◽  
Author(s):  
Mihailo Bezmarevic ◽  
Zoran Kostic ◽  
Miodrag Jovanovic ◽  
Sasa Mickovic ◽  
Darko Mirkovic ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Form ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Serum Concentrations ◽  
Key Factors ◽  
Early Assessment ◽  
Adequate Treatment ◽  
Reactive Protein ◽  
Score Apache

Background/Aim. Early assessment of severity and continuous monitoring of patients are the key factors for adequate treatment of acute pancreatitis (AP). The aim of this study was to determine the value of procalcitonin (PCT) and Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring system as prognostic markers in early stages of AP with comparison to other established indicators such as Creactive protein (CRP) and Acute Physiology and Chronic Health Evaluation (APACHE) II score. Methods. This prospective study included 51 patients (29 with severe AP). In the first 24 h of admission in all patients the APACHE II score and BISAP score, CRP and PCT serum concentrations were determined. The values of PCT serum concentrations and BISAP score were compared with values of CRP serum concentrations and APACHE II score, in relation to the severity and outcome of the disease. Results. Values of PCT, CRP, BISAP score and APACHE II score, measured at 24 h of admission, were significantly elevated in patients with severe form of the disease. In predicting severity of AP at 24 h of admission, sensitivity and specificity of the BISAP score were 74% and 59%, respectively, APACHE II score 89% and 69%, respectively, CRP 75% and 86%, respectively, and PCT 86% and 63%, respectively. It was found that PCT is highly significant predictor of the disease outcome (p < 0,001). Conclusion. In early assessment of AP severity, PCT has better predictive value than CRP, and similar to the APACHE II score. APACHE II score is a stronger predictor of the disease severity than BISAP score. PCT is a good predictor of AP outcome.

The role of pulse oximetry in the early assessment of acute pancreatitis

Pancreatology ◽  
2012 ◽  
Vol 12 (3) ◽  
pp. e17
Author(s):  
L. El-Asir ◽  
J. Bird ◽  
G. Middleton ◽  
R. Farrell
Keyword(s):  
Acute Pancreatitis ◽  
Pulse Oximetry ◽  
Early Assessment

scholarly journals Role of C-reactive protein in predicting the outcome of acute pancreatitis

2021 ◽  
Vol 9 (1) ◽  
pp. 165
Author(s):  
Venkatesh S. ◽  
Neetha V. ◽  
Manish S. ◽  
Krishnan P. B.
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Practice ◽  
Scoring Systems ◽  
C Reactive Protein ◽  
Early Assessment ◽  
Serum Lipase ◽  
Protein Levels ◽  
Reactive Protein ◽  
Delayed Recovery

Background: Acute pancreatitis is one of the most commonly encountered clinical entities in surgical practice and controversy still exists regarding the clinical features of acute pancreatitis. An early diagnosis, however, is regarded as mandatory for successful treatment. Over the years many Authors have proposed different scoring systems for the early assessment of the clinical evolution of acute pancreatitis. The most widely used scoring systems are often cumbersome and difficult to use in clinical practice because of their multi factorial nature. Thus, a number of unifactorial prognostic indices have been employed in routine hospital practice, such as C-reactive protein (CRP), serum amylase and serum lipase. These serum enzymes are easy to obtain in normal clinical practice and many authors consider them as reliable as multi factorial scoring systems.Methods: A hospital based observational prospective study was done with 30 patients to measure C reactive protein levels in patients of acute pancreatitis and evaluate if CRP levels predict the severity of pancreatitis.Results: In cases where CRP was raised >100 mg/dl on day 7 and beyond showed either a complication or increased duration of stay and delayed recovery. This correspondence of CRP with the clinical outcome co related well with other parameters like blood counts, serum lipase and amylase levels too.Conclusions: Hence, CRP can be a very useful uni factorial tool in assessing and thereby predicting the outcome in a case of pancreatitis.

The Role of Nonenhanced Magnetic Resonance Imaging in the Early Assessment of Acute Pancreatitis

2007 ◽  
Vol 102 (5) ◽  
pp. 997-1004 ◽  
Author(s):  
Davor Štimac ◽  
Damir Miletić ◽  
Mladen Radić ◽  
Irena Krznarić ◽  
Marzena Mazur-Grbac ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Acute Pancreatitis ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Early Assessment

scholarly journals Role of Biomarkers in Diagnosis and Prognostic Evaluation of Acute Pancreatitis

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Susanta Meher ◽  
Tushar Subhadarshan Mishra ◽  
Prakash Kumar Sasmal ◽  
Satyajit Rath ◽  
Rakesh Sharma ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Biochemical Markers ◽  
Necrotizing Pancreatitis ◽  
Pancreatic Tissue ◽  
Pancreatic Acinar Cell ◽  
Early Assessment ◽  
Prognostic Evaluation ◽  
Reactive Protein ◽  
Life Threatening

Acute pancreatitis is a potentially life threatening disease. The spectrum of severity of the illness ranges from mild self-limiting disease to a highly fatal severe necrotizing pancreatitis. Despite intensive research and improved patient care, overall mortality still remains high, reaching up to 30–40% in cases with infected pancreatic necrosis. Although little is known about the exact pathogenesis, it has been widely accepted that premature activation of digestive enzymes within the pancreatic acinar cell is the trigger that leads to autodigestion of pancreatic tissue which is followed by infiltration and activation of leukocytes. Extensive research has been done over the past few decades regarding their role in diagnosis and prognostic evaluation of severe acute pancreatitis. Although many standalone biochemical markers have been studied for early assessment of severity, C-reactive protein still remains the most frequently used along with Interleukin-6. In this review we have discussed briefly the pathogenesis and the role of different biochemical markers in the diagnosis and severity evaluation in acute pancreatitis.

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