Early prediction capabilities for the severity of acute pancreatitis

Objective of the study: to determine the possibility of early isolation of a group of patients with severe acute pancreatitis and moderate acute pancreatitis using prognostic scales and individual indices. Material and methods. The study includes 201 patients with acute pancreatitis who were treated at the Clinic of Faculty Surgery and Oncology of the University Clinical Hospital No. 1 of Saratov State Medical University named after V.I. Razumovsky. 39 patients were operated on. Results. As a result of the study, it was found that in the group of patients with mild acute pancreatitis, it was 6.8; in the group with moderate acute pancreatitis - 10.1; in the group with severe acute pancreatitis - 11.0. When using the Kruskall-Waliss test, significant differences were obtained between the groups, as well as when comparing the groups "mild acute pancreatitis - moderate acute pancreatitis.” When comparing the groups of "acute pancreatitis of moderate severity - severe acute pancreatitis,” no significant differences were obtained. The mean value of acute severe pancreatitis in patients with mild acute pancreatitis in our work is 174.8; in patients with moderate acute pancreatitis - 209.6; in patients with severe acute pancreatitis - 224.0. When comparing the three groups, the differences between them turned out to be statistically significant. They turned out to be the same when comparing the groups "mild acute pancreatitis - moderate acute pancreatitis.” Whereas when comparing "moderate acute pancreatitis - severe acute pancreatitis,” the differences are unreliable. Thus, the BISAP, HAPS, IMRIE scales, prognostic signs when comparing three groups of patients help to stratify them by severity of acute pancreatitis. The same results were obtained in a separate comparison of the groups of patients with mild acute pancreatitis and moderate acute pancreatitis. However, none of the scales and relationships we applied allows, unfortunately, to distinguish between patients with moderate acute pancreatitis and severe acute pancreatitis upon admission. This problem needs further investigation. Conclusions. 1. To predict the severity of acute pancreatitis, it is possible to use both prognostic systems (BISAP, HAPS, IMRIE) and individual simple prognostic criteria. 2. The use of severity scales for patients with acute pancreatitis made it possible to isolate in the first hours after admission to the hospital patients with mild acute pancreatitis on the one hand and patients with moderate acute pancreatitis on the other. 3. Early isolation from the general cohort of patients with moderate acute pancreatitis allows initiating intensive therapy early and thereby improving treatment outcomes.