Severe acute pancreatitis: prognostic criteria

Abstract

Introduction: The timely prognosis of course of acute pancreatitis allows correctly choosing tactics of treatment, warning development of complications. Method: There is an analysis of treatment of 125 patients with severe acute pancreatitis. All patients were operated. In postoperative period 34 (27,2%) patients died. Reaction of periphery blood by hematological indexes (one of these hematological indexes – the intoxication indicator – offered by us); estimation of severity of the patient’s state by the Acute Sepsis Severity Evaluation Scale; impact of parapancreatic fat injury; presents of accompanying diseases in dynamics of treatment of the patients were studied. Results: It was revealed, that values of the index of organism’s resistance less than 31,59; the leukocyte intoxication index more than 8,18; the reactive neutrophilic response index more than 40,77; the intoxication indicator more than 1,14 are the factors of adverse outcome of severe acute pancreatitis (р <0,05)At severity of the patient’s state by the Acute Sepsis Severity Evaluation Scale in a preoperative period more than 13 points mortality in a postoperative period was 51,85%, less than 13 points - 19,44%. In an early postoperative period at severity of the patient’s state more than 16 points mortality was 70,59%, less than 16 points - 11,11% Parapancreatic fat injury is revealed at 80 (64,0%) patients. At 26 (76,5%) patients from 34 died parapancreatic fat injury revealed. Thus parapancreatic fat injury increase lethality risk on 32,5%. Analyze of presents of accompanying diseases shown, that patients with cachexia, obesity, inefficiency of cardiovascular system had statistically higher (р <0,05) mortality risk.Conclusion: The values of the indexes of peripheral blood, individual estimation of patient’s state by the Acute Sepsis Severity Evaluation Scale, presents of parapancreatic fat injuring and presents of accompanying diseases are prognostic criteria of course of severe acute pancreatitis.