Improving diagnosis of alcohol-induced acute necrotizing pancreatitis
- VernacularTitle:Архины шалтгаант нойр булчирхайн цочмог үхжилт үрэвслийн оношилгоог боловсронгуй болгох нь
- Author:
Erdenebold D
1
;
Baasanjav N
1
;
Batbold B
1
;
Puntsag Ch
2
;
Ganbaatar M
2
;
Altankhuyag S
2
Author Information
1. Ach Medical University
2. The Third State Central Hospital
- Publication Type:Journal Article
- Keywords:
Аcute pancreatitis;
Acute necrotizing pancreatitis;
Procalcitonin;
C-reactive protein;
Serum lipase
- From:Mongolian Medical Sciences
2021;195(1):25-30
- CountryMongolia
- Language:Mongolian
-
Abstract:
Introduction:About 20-30% of patients with acute pancreatitis have a severe disease and mortality rate among
inpatients were 15%. There are many causes of acute pancreatitis (AP), but most common cause of
AP is an alcohol. According to some studies in our country, alcohol is the number one cause of acute
pancreatitis and the mortality rate is 15.3%. Very important for prognosis of disease optimal choice
of treatment tactics, detection of infectious evidence of necrotizing pancreatitis. Therefore, based on
the above, there is an urgent need to conduct research to address important issues and to improve
the diagnosis and treatment of acute alcohol-induced pancreatic necrosis.
Goal:Determine the importance of early diagnostic assessment of alcohol induced severe acute necrotizing
pancreatitis.
Materials and Methods:Research model and research method. We conducted our research using an observational research
model and a factual research method.Sampling of research materials will be carried out by targeted
sampling. From November 1, 2008 to January 1, 2020, 122 patients who were hospitalized with
alcohol-inducedAP were selected and archival documents or medical histories were selected.
Statistical analysis was performed using averages and regression analysis methods to calculate the
laboratory parameters in the analysis related to the new evaluation system.
Results:The minimum age of patients with ANP was 25 and the maximum was 71, with the majority (87.4%)
aged 26 to 60 years. When the Person Correlation method calculates the relationship between
alcohol consumption and mortality, it is assumed that the weaker the correlation, the higher the
amount of alcohol consumed, the lower the cure and the higher the mortality. Of the 31 deaths
reported in the study, 24 (77.4%) were hospitalized more than 72 hours after the onset of the disease.
Late hospitalization and late treatment of patients with acute necrotizing pancreatitis (ANP) disease
have been shown to adversely affect the prognosis of the disease. In our study, all parameters were
significant, but procalcitonin, serum amylase, serum lipase, serum LDG8 C-reactive protein, serum
glucose was found to be higher than the value specified in the evaluation system for the variable (in determining pancreatic necrosis). АNOVA analysis test showed that white blood cells, procalcitonin,
serum amilza, serum lipaza, serumglucose, serum LDG, C-reactive protein were higher than those
specified in the evaluation system, and that the level of significance for the variable (indicating a
severe pancreatitis or poor prognosis) was higher than other test results (P <0.01). According to
the new evaluation system, 12 out of 122 patients were classified as A class or 0-3, 69 (56.5%)
patients were class B or 4-6, and 41 (33.6%) patients were class C or >7 points. Of the total cases,
90.1% were rated as severe form of ANP and pancreatic necrosis by the classification system we
developed. When we assessed the prognosis with the new assessment system, we found that 100
percent of patients in category A were cured, 89.8 percent of patients in category B were cured, and
41.5 percent of patients in category C were cured and 58.5 percent died. Statistical calculations using
the correlation analysis method for the correlation between the score and the cure of the evaluation
system shows negative correlation (P <0.01) other words, the higher the score of the evaluation
system, the lower the cure rate and the higher the mortality rate.
Conclusion:In Mongolia, relatively young men suffer from alcohol-induced pancreatitis.Factors contributing to the
development of necrosis in acute pancreatitis include alcohol abuse, prolonged alcohol use, delayed
hospitalization, and delayed treatment.In our study, following clinical signs and laboratory findings are
effective in distinguishing severe forms of acute necrotizing pancreatitis, early diagnosis, assessment
of prognosis. Laboratorytests include: increase in white blood cells, procalcitonin, serum amylase,
serum LDH, serum lipase, C-reactive protein and a decrease in hematocrit, serum calcium.
- Full text:2021-195(1)-25-30.pdf
