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Validation of 'moderately severe acute pancreatitis' in patients with acute pancreatitis
Paleswan Joshi Lakhey1, Ramesh Singh Bhandari1, Brindeshwori Kafle1
1Department of Surgery, TUTH, Kathmandu, Nepal.
Introduction:
Severe acute pancreatitis, according to Atlanta classification, is a heterogeneous group of patients with different outcomes. The patients with local complications and without organ failure have better outcome. This study has been conducted to determine the proportion of moderately severe acute pancreatitis and validate this subgroup in our population of patients.
Methods:
A total of 172 patients with the diagnosis of acute pancreatitis were categorized into three groups according to presence or absence of local complications and organ failure as mild acute pancreatitis, moderately severe acute pancreatitis and severe acute pancreatitis and were compared in terms of need for intensive care unit care, length of ICU stay, need for intervention, length of hospital stay and mortality.
Results:
Fifty seven (33%) were categorized as moderately severe acute pancreatitis. Need for ICU care (19.3% vs 100%, p<0.001), length of ICU stay (1 vs 9.8 days, p<0.001), length of hospital stay (8.3±3.7 vs 16.6±8.1 days, p<0.001) and mortality (0% vs 33.3%, p<0.001) between moderately severe acute pancreatitis and severe acute pancreatitis was significantly different. Moreover, mild acute pancreatitis and moderately severe acute pancreatitis had no mortality.
Conclusions:
This study showed that moderately severe acute pancreatitis exists as a separate group different from mild acute pancreatitis and severe acute pancreatitis with no mortality as in mild acute pancreatitis.
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