Acute Pancreatitis

Banks, Peter A.

doi:10.1097/mpa.0000000000000632

Cited by 26 publications

(14 citation statements)

References 71 publications

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“…AP is an inflammatory condition of the pancreas and may have a variable severity. Most of the patients have mild disease with minimal morbidity, and the rest of the patients have 10%-20% of mortality in SAP [6]. In this study based on MCSI, there were 69 (42%) SAP patients who are similar to Bezmarevic et al study [7].…”

Section: Discussionsupporting

confidence: 55%

Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study

Venkatesh¹,

Vijayakumar²,

Balasubramaniyan³

et al. 2020

Cureus

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Background Acute pancreatitis (AP) is an inflammatory condition of the pancreas mostly due to alcohol or gallstones. Various scoring systems were involved in identifying the severity of the disease. The standard single score to identifying the severity remains uncertain. Methodology This prospective observational study was carried out for two years in a tertiary care center from South India. The diagnosis of AP was made based on Atlanta criteria, and a total of 164 patients were included. All patients were assessed by acute physiology and chronic health evaluation ll (APACHE II), bedside index for severity in AP (BISAP), modified Glasgow score (MGS), and Ranson score on admission and 48 hours after admission scores. Procalcitonin was done in all patients with AP. Contrast-enhanced computed tomography (CT) of the abdomen was done in 69 patients who had features of severe acute pancreatitis (SAP). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for each score, and procalcitonin for CT documented severe patients and organ failure patients together. Results A total of 164 patients were included in this study. CT abdomen showed a modified CT severity index (MCSI) ≥8 in all 69 (100%) patients. APACHE II score could predict SAP based on CT findings in 44 patients (63.76%), BISAP score in 22 patients (31.88%), MGS in 55 patients (79.71%), Ranson score at admission in 31 patients (44.92%), Ranson score 48 hours after admission in 44 patients (63.76%), and procalcitonin on admission in 69 patients (100%) when cutoff used as per the literature. APACHE II score could predict SAP in cases of AP (n=164) in 52 patients (50%), BISAP score in 27 patients (26%), MGS in 79 patients (76%), Ranson score at admission in 34 patients (33%), and Ranson score 48 hours after admission in 61 (59%) patients when cutoff was used as per the literature. This study demonstrated that Ranson score on admission had a good area under the curve (AUC). AUC (0.8483), APACHE II (AUC 0.7708), and Ranson score 48 hours after admission (AUC 0.8167) had a fair accuracy. BISAP (AUC 0.6399) and MGS (AUC 0.6486) had poor accuracy for the prediction of severity in AP based on receiver operator characteristic (ROC) curves.

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Section: Discussionsupporting

confidence: 55%

Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study

Venkatesh¹,

Vijayakumar²,

Balasubramaniyan³

et al. 2020

Cureus

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“…The severity of AP was defined according to the revised Atlanta classification system [ 10 , 19 ]. Patients who did not present any local/systemic complications nor organ failure were assigned to the mild acute pancreatitis (MAP) group.…”

Section: Methodsmentioning

confidence: 99%

“…BISAP includes five components: BUN ≥ 25 mg/dL (or urea ≥ 8.93 mmol/L); impaired mental status; presence of SIRS; age > 60 years; and evidence of pleural effusion [ 41 ]. Ranson’s score was computed using appropriate data from days 1 and 2 of hospital stay [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

“…A wide range of diagnostic tests is used for the evaluation of AP severity in early phase, including imaging tests (primarily computed tomography with contrast, or magnetic resonance imaging), multi-variable prognostic scales (e.g., bedside index of severity in AP (BISAP)), Ranson’s scale, Glasgow scale, Acute Physiology and Chronic Health Evaluation (APACHE II), as well as single laboratory markers [ 9 , 10 ]. Among single biomarkers, C-reactive protein (CRP) and procalcitonin (PCT) are most widely used in daily clinical practice [ 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Does the Automatic Measurement of Interleukin 6 Allow for Prediction of Complications during the First 48 h of Acute Pancreatitis?

Kolber¹,

Dumnicka

Maraj

et al. 2018

IJMS

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Acute pancreatitis (AP) in most patients takes a course of self-limiting local inflammation. However, up to 20% of patients develop severe AP (SAP), associated with systemic inflammation and/or pancreatic necrosis. Early prediction of SAP allows for the appropriate intensive treatment of severe cases, which reduces mortality. Serum interleukin-6 (IL-6) has been proposed as a biomarker to assist early diagnosis of SAP, however, most data come from studies utilizing IL-6 measurements with ELISA. Our aim was to verify the diagnostic usefulness of IL-6 for the prediction of SAP, organ failure, and need for intensive care in the course of AP using a fully automated assay. The study included 95 adult patients with AP of various severity (29 mild, 58 moderately-severe, 8 severe) admitted to a hospital within 24 h from the onset of symptoms. Serum IL-6 was measured using electochemiluminescence immunoassay in samples collected on admission and on the next day of hospital stay. On both days, patients with SAP presented the highest IL-6 levels. IL-6 correlated positively with other inflammatory markers (white blood cell and neutrophil counts, C-reactive protein, procalcitonin), the markers of renal injury (kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin), and the markers of endothelial dysfunction (angiopoietin-2, soluble fms-like tyrosine kinase-1). IL-6 on admission significantly predicted SAP, vital organ failure, and the need for intensive care or death, with areas under the receiver operating curve between 0.75 and 0.78, not significantly different from multi-variable prognostic scores. The fully automated assay allows for fast and repeatable measurements of serum IL-6, enabling wider clinical use of this valuable biomarker.

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“…In approximately 50 percent of patients, the pain radiates to the back. 29 The pain persists for several hours to days and may be partially relieved by sitting up or bending forward. Approximately 90 percent of patients have associated nausea and vomiting which may persist for several hours.…”

Section: Clinical Presentationmentioning

confidence: 99%

The management of the patient with acute pancreatitis: from evidence to clinical practice

Cenci

Restuccia

Gnerre³

et al. 2017

Ital J Med

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Acute pancreatitis is an inflammatory disorder of the pancreas characterized by abdominal pain and elevation of pancreatic enzymes in the blood. The pathogenesis is complex and partly unknown and the evolution is often unpredictable. Many efforts have been made to define this disease and its complications and to classify different grades of severity in order to formulate prognostic scores that could guide the physician in choosing the optimal therapeutic setting and procedures. The management of the patient with pancreatitis is not always optimal and differs among internist, gastroenterologist or surgeon. We think that a patient with clinical suspicion of acute pancreatitis is admitted to medical or surgical department depending on the availability of beds and not according to evidence-based medicine. The aim of this monograph is to identify the optimal management of patients with acute pancreatitis admitted to hospital.

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Acute Pancreatitis

Cited by 26 publications

References 71 publications

Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study

Comparison of Different Scoring Systems in Predicting the Severity of Acute Pancreatitis: A Prospective Observational Study

Does the Automatic Measurement of Interleukin 6 Allow for Prediction of Complications during the First 48 h of Acute Pancreatitis?

The management of the patient with acute pancreatitis: from evidence to clinical practice

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