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