Factors Leading to Acute Pancreatitis in Tertiary Care Hospitals in Pakistan – A Multicenter Study

• Main Authors: Tahira Hameed, Ammar Zaman Khan, Inamullah Shah, Abdul Qadeer Khan, Murtaza Ahmad
• Format: Article
• Language: English
• Published: Rawalpindi Medical University 2018-03-01
• Series: Journal of Rawalpindi Medical College
• Subjects: Acute pancreatitis; Cholelitheasis; Ranson score
• Online Access: https://www.journalrmc.com/index.php/JRMC/article/view/847
• ISSN: 1683-3562; 1683-3570

Background: To determine the prevalence, etiological spectrum and outcomes of acute pancreatitis patients . Methods: In this was descriptive, observational, study patients presenting with clinical features of acute pancreatitis, increased serum amylase and/or lipase levels and/or CT scan abdomen with features suggestive of acute pancreatitis were included. Ranson’s scoring was done over the first 48 hours. Contrast- enhanced CT scan abdomen with pancreatic protocol was done in selected patients. Cochrane-Armitage trend test was used to determine significance of correlation between complications and severity indices. Results: Out of 154 patients 59.1% were female. Gall stones (74%) was the commonest aetiology, followed by idiopathic ( 13%). Same admission cholecystectomy was done in 44.7% of patients with gallstone pancreatitis. On admission, 14.9% of serum amylase and 18.8% (n=29) of serum lipase levels were within 3 times the upper limit of normal values. Higher Ranson’s score and modified CT severity index were associated with higher complication and mortality rates. The complication rate was 21.4 % and mortality was 7.1 % . Conclusion: Gallstone pancreatitis was found to be the most common cause. The higher rate of idiopathic pancreatitis in our study, along with higher mortality in this subgroup, could be partially explained due to lack of advanced diagnostics such as MRCP and EUS. Overall complication and mortality rate was higher for which healthcare infrastructure needs to be improved.