Risk Factors for Worsening of Acute Pancreatitis in Patients Admitted with Mild Acute Pancreatitis

Abstract

BackgroundThe aim of the present study was to investigate risk factors for developing more severe pancreatitis, including moderately severe (MSAP) and severe acute pancreatitis (SAP), in patients admitted with mild acute pancreatitis (MAP).Material/MethodsPatients admitted with MAP to our hospital from March 2013 to May 2016 were included and prospectively evaluated. Possible risk factors for developing MSAP or SAP were age, blood glucose level on admission, etiology, sex, Ranson score, amylase level, Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores, C-reactive protein (CRP) level, serum calcium level, visceral fat area (VFA), body mass index (BMI), whether this was the first episode of AP, and method of administration of octreotide. The effects of variables for developing MSAP or SAP were evaluated using univariate and multivariate logistic regression models. Mortality, hospital duration, and rate of ICU transfer of patients were compared between patients who developed MSAP or SAP and patients who did not.ResultsA total of 602 patients admitted with MAP were recruited into this study (256 men and 346 women). Seventy-four patients (12.3%) developed MSAP or SAP. According to univariate logistic regression analyses, the results indicated that there were 5 significant differences between patients who developed MSAP or SAP and those who did not: VFA (>100 cm2) (p=0.003), BMI (≥25 kg/m2) (p=0.001), Ranson score(p=0.004), APACHE-II (≥5) (p=0.001), and blood glucose level on admission (>11.1 mmol/L) (p=0.040). Further multivariate logistic regression analyses revealed that BMI (≥25 kg/m2) (p=0.005), APACHE-II (≥5) (p=0.001), and blood glucose level on admission (>11.1 mmol/L) (p=0.004) were independent risk factors for developing MSAP or SAP in patients admitted with MAP. Moreover, patients who developed MSAP or SAP had a mortality rate of 5.4%.ConclusionsSignificant risk factors for developing MSAP or SAP in patients admitted with MAP included BMI (≥25 kg/m2), APACHE-II (≥5), and blood glucose level on admission (>11.1 mmol/L). These factors should be used in the prediction of more severe pancreatitis in patients admitted with MAP.

Clinical efficacy of duodenoscopy combined with laparoscopy in the treatment of patients with severe acute pancreatitis and pancreatic pseudocyst, and the effects on IL‑6 and CRP

“…Some studies have also reported that different surgical methods directly affect the prognosis of patients (25)(26)(27). A recent study has confirmed that the prognosis of patients with SAP also needs long-term monitoring of serum inflammatory factors (28). The present study focused on the clinical efficacy of duodenoscopy combined with laparoscopy in the treatment of patients with SAP and PP.…”

Assessment of Health-Related Quality of Life and Risk Factors Associated With Pancreatitis in a Tertiary Care Hospital

“…It is a long-lasting condition shows impact on the physical health and well-being of people. The risk factors associated are gallstones, alcohol, trauma, infections, hypercalcemia, and hypertriglyceridemia [10][11][12][13].…”

Effectiveness of continuous veno-venous hemofiltration in the treatment of severe acute pancreatitis

“…Acute pancreatitis (AP) is a common emergency. AP patients suffer from inflammatory responses such as bleeding, edema and necrosis caused by pancreatic tissue digestion due to abnormally activated pancreatic trypsin resulting from various factors such as drinking, overeating, hyperlipidemia and cholelithiasis ( 1 , 2 ). The clinical manifestations of AP patients are acute and persistent abdominal pains, accompanied with clinical symptoms including nausea, vomiting, fever and stop of flatus and defecation in most patients ( 3 ).…”