An observational pilot study to determine factors predicting survival and mortality in acute pancreatitis

Introduction: Acute Pancreatitis involves a rapid inflammatory cascade leading to
parenchymal injury. 80-90% of cases are self limiting while the rest lead to a much severe form of disease. Despite strict protocols and various markers of pancreatitis, it has
a high mortality rate. This pilot study is a small scale test of the methods and
procedures to be used on a larger scale for evaluating clinical, biochemical and radiological parameters that predict need for intervention, morbidity and mortality.
Methodology: This Pilot study took place in a tertiary care hospital among 50 patients of acute pancreatitis for one year. Various clinical parameters were used to identify
severity of disease. Ranson's score was used to access biochemically demonstrated
severity and CT severity score to access radiological severity.
Results and Discussion: Out of 50 patients 38 were male with average age of 31-50 years and 78%were alcoholic. 80% patients had Systemic Inflammatory Response Syndrome. Ranson Score at admission greater than 3 was only 2% which increased to 10% after 48 hours. 18 patients required intervention viz percutaneous drainage, ERCP, or surgery.
Conclusion: Acute pancreatitis was more common in alcoholics and male gender. There was no significant association between Ranson Score and need for intervention (p=0.23). Ranson Score and CT Severity score had no statistical significance in predicting mortality (p=0.48, p=0.11). Detailed analysis was not done from the pilot study as the small sample size had already proved that there were no statistically significant findings with the given parameters. The study design however proved to be feasible for a larger study of 100 patients. This was the main reason behind conducting this pilot study with hope to work on larger data from the final study.