Early identification of patients at risk of acute severe pancreatitis with Systemic Inflammatory Response Syndrome score at admission

Authors

  • Uttam Laudari Lecturer, Patan Academy of Health Sciences, Lagankhel, Lalitput, Nepal.
  • Abishek Thapa Lecturer, KIST Medical College, Lalitpur, Nepal.
  • Tanka Prasad Bohara Associate Professor, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
  • Shail Rupakheti Consultant, Star Hospital, Lalitpur, Nepal.
  • Mukund Raj Joshi Professor, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.

DOI:

https://doi.org/10.3126/jkmc.v8i2.28171

Keywords:

Pancreatitis; Severity; Systemic Inflammatory Response Syndrome.

Abstract

Background: Clinically, the Systemic Inflammatory Response Syndrome (SIRS) is identified by two or more symptoms including fever or hypothermia, tachycardia, tachypnea and change in blood leukocyte count. The relationship between SIRS symptoms at the time of presentation and severity of pancreatitis is yet to be determined though progression of SIRS in subsequent days has already been correlated.
Objectives: To determine the severity of pancreatitis with SIRS score at the time of admission.
Methodology: A retrospective cohort study of patients admitted to Department of Surgery, Kathmandu Medical College Teaching Hospital (KMCTH) with diagnosis of Acute Pancreatitis (AP) from December 2014 to January 2016 was conducted. Clinical, biochemical and imaging data were collected from the medical record section. Patients with diagnosis of acute pancreatitis as per Revised Atlanta Classification 2012 were included in the study. SIRS score at time of admission was correlated with Modified Marshall scoring system for organ dysfunction. Patients were grouped into severe and nonsevere group. Sensitivity, specificity and predictive values of SIRS score at admission for organ failure were calculated.
Results: Among the 41 patients admitted with diagnosis of acute pancreatitis irrespective of cause, the sensitivity of SIRS score ≥2 at admission in predicting severe pancreatitis was 60 %, specificity was 20%, positive predictive value was 28% and negative predictive value was 20 %, with p-value of 0.52 and odds ratio of 1.6 (CI: 0.376-6.808).
Conclusion: SIRS score at admission cannot be solely used in predicting acute severe pancreatitis. Patients can be stratified in resource deficit setting for timely referral to tertiary centre.

Downloads

Download data is not yet available.
Abstract
228
PDF
184

Author Biography

Uttam Laudari, Lecturer, Patan Academy of Health Sciences, Lagankhel, Lalitput, Nepal.

Lecturer

Downloads

Published

2019-06-30

How to Cite

Laudari, U., Thapa, A., Bohara, T. P., Rupakheti, S., & Joshi, M. R. (2019). Early identification of patients at risk of acute severe pancreatitis with Systemic Inflammatory Response Syndrome score at admission. Journal of Kathmandu Medical College, 8(2), 92–95. https://doi.org/10.3126/jkmc.v8i2.28171

Issue

Section

Original Research Articles

Most read articles by the same author(s)