Sever acute pancreatitis: assessment of clinical characteristics, imaging data, accompanying pathology, complications and consequences

Abstract

Introduction. The issue of early stratification of patients with acute pancreatitis (AP) by severity is crucial in order to start infusion therapy in time and reduce the mortality rate. Aim. The analysis of clinical characteristics, imaging data, concomitant pathology, complications and consequences of severe acute pancreatitis was carried out in this study. Materials and methods. In this work, a detailed analysis of the clinical data of 131 patients with severe AP was carried out, including epidemiological, clinical data, as well as the development of local complications based on the results of imaging methods, such as computer tomography, ultrasound, and radiological methods. All patients with AP were divided into two groups: the deceased group, consisting of 59 patients, and the discharged group, consisting of 72.Results. In-hospital mortality in patients with severe AP was 45,0%. The trend towards older age in the deceased group persists. The vast majority of deceased patients (59,4%) were admitted to a hospital within 24 hours of the onset of symptoms. Men predominated in the total sample: their ratio to women was 1,6 to 1,0, p=0,006. However, an increase in the proportion of women was noted in the group of the deceased (47,5% versus 31,9%, p=0,07 according to the χ2 test for independent groups). The aseptic necrotic form of AP was dominant both in the group of deceased and in the group of discharged patients–38 (64,4%) versus 38 (52,8%), respectively (p=0,18). The alcoholic genesis of AP was significantly more frequent in the group of the deceased compared to the group of those discharged (35,6% vs. 11,1%, p=0,0008). In terms of the frequency of concomitant pathology, the groups of deceased and discharged patients did not differ (93,2% and 90,3%, respectively). Diabetes and obesity slightly prevailed in the group of the deceased. Complications were significantly more common in the deceased group than in the discharged group (100% compared to 81,9%, p=0,0006). Also, all three imaging methods (ultrasound, XR and CT) showed a different frequency of detection of fluid collections in patients with severe AP depending on the anatomical locations.