Severe Acute Pancreatitis: Prognostic Criteria

1
Severe Acute Pancreatitis Prognostic
Criteria Vasyl Syplyviy, Vsevolod Robak,
Volodymyr Dotsenko, Dmytro Ievtushenko, Alexander
Ievtushenko
Department of General Surgery ?2Kharkiv National
Medical University, Ukraine.
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 patients 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 organisms 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 (? lt0,05)(fig 1).
Cut-off value 8.18
Cut-off value 1.14
Cut-off value 40.77
Cut-off value 31.59
Fig. 1 Values of the hematological indexes in
patients with severe acute pancreatitis
significantly associated with the outcome of
severe acute pancreatitis and it's cut-off values
At severity of the patients 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 patients state more
than 16 points mortality was 70,59, less than 16
points - 11,11 (fig 2).
preoperative period
postoperative period
Fig. 2 Mortality levels associated with
estimation of severity of the patients state by
the Acute Sepsis Severity Evaluation Scale
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 (? lt0,05) mortality risk.
Conclusion The values of the indexes of
peripheral blood, individual estimation of
patients 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.