An audit of fatal acute pancreatitis

Abstract

SummaryAcute pancreatitis has a mortality of about 10%: this figure has not changed over the last 20 years. A retrospective audit of fatal acute pancreatitis was performed in a teaching hospital with a catchment population of about 750 000 patients to examine patient charactistics. Using Hospital Activity Analysis code 577.0, all fatal cases of acute pancreatitis were studied in a six-year period 1987-93. Additionally, all post mortem diagnoses of acute pancreatitis were traced. The overall post mortem rate in Nottingham at the time ofthe study was about 35 %. All available records, X-ray and biochemical data were studied and appropriate information recorded and analysed for 65 fatal cases. Only 15% were post mortem diagnoses, lower than in previous series; 72% had respiratory and 67% had renal complications. Only 34% had been admitted to the intensive care unit. A third of patients had had surgery; 67% of these was some form of external drainage. England' and in Finland9: we therefore wished to examine whether recent advances in treatment had altered the outcome of severe acute pancreatitis. We were also able to compare our

Acute pancreatitis and the influence of socioeconomic deprivation

“…Most epidemiological data on AP are based on electronic hospital episode statistics (HES), which lack clinical detail and carry inherent flaws of potentially incomplete case inclusion 14,15 . In studies by Banerjee and colleagues 16 and Thomson and co-workers 17 , in which multiple methods of patient identification were used, HES provided only 50-53 per cent of all identified cases of AP. Raised serum levels of pancreatic enzymes (amylase or lipase) are biochemical tests with high sensitivity and specificity for AP 18 .…”

The management of severe acute necrotising pancreatitis: an evidence-based review of the literature

“…In a majority of patients a treatable underlying cause is identified. Although mild, interstitial, oedematous pancreatitis is more common; the more severe form, acute necrotising pancreatitis (ANP) is associated with a mortality of 27±45 % [1]. Management of patients with severe ANP is time-consuming, and labour and resource intensive.…”

Clinical significance of Urinary Amylase in Acute Pancreatitis

“…Serum / urinary amylase measurement is a standard diagnostic method, although it was shown to be unable to recognize one ifth of acute pancreatitis patients [1]. The severity of acute pancreatitis forms a continuum, and the average mortality rate approaches 2-10% [2][3][4]. Most of the cases are mild and conservative treatment results in a rapid recovery in most of them.…”