Rajarajan, R (2020) Comparative study of Various Scores in Predicting Complications and Mortality in Acute Pancreatitis. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
Acute pancreatitis is a condition in which there is sudden inflammation in pancreas. It ranges from self limiting mild inflammation to life threatening severe disease, the severe acute pancreatitis (SAP). SAP has been a challenge to surgeons world wide because of its association with many complications and high mortality rate. The overall mortality in acute pancreatitis is noted in range of 5–10%. Among them 80–90% of cases are of mild pancreatitis with a good outcome. The remaining 10–20% of patients are of SAP and noted to have mortality rate of up to 40%. So, early identification of patients with severe disease is beneficial to anticipate prognosis and complications so patients at risk can be provided adequate monitoring and care. Many scoring systems has been described over the time to identify severe cases and patients at risk to develop complications and higher mortality by using multiple hematological, biochemical , radiological, clinical and hemodynamic criteria. Three of the commonly used scoring systems are: 1. BISAP (Bedside Index of Severity in Acute Pancreatitis) which considers 5 criteria- blood urea nitrogen level, mental status, evidence of Systemic inflammatory response syndrome, age, and evidence of plural effusion. 2. Ranson’s score, which considers 11 criteria- Age, Blood glucose level, white blood counts, serum lactate dehydrogenase levels, serum aspartate aminotransferase level, decrease in hematocrit levels, increase in blood urea nitrogen, serum calcium levels, partial oxygen pressure levels, base deficit, fluid sequestration. 3. Modified CTSI (Computed Tomography Severity Index) which considers 3 aspects of CT findings- pancreatic inflammation, pancreatic necrosis and extra pancreatic complications. Each scoring system has its distinct method of evaluating severity, BISAP scoring system 2 focuses on inflammatory response and its effect, RANSON’S scoring assesses biochemical changes through 48 hour of time period, modified CTSI score assesses severity by anatomical changes like inflammation, pancreatic necrosis. These three scoring system are being compared in present study to find out which of these score is better screening method and accurately predicts mortality, complication such as renal failure, respiratory failure, multiorgan failure, pancreatic necrosis accurately.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711159 |
| Uncontrolled Keywords: | Acute Pancreatitis, Predicting Complications, Mortality, Comparative study. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Feb 2021 16:02 |
| Last Modified: | 10 Feb 2021 16:02 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13990 |
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