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Year : 2022  |  Volume : 28  |  Issue : 1  |  Page : 20-23

Arterial pH, bicarbonate levels and base deficit as predictors of morbidity and mortality in acute pancreatitis

Department of General Surgery, MOSC Medical College, Kolenchery, Kerala, India

Correspondence Address:
Dr. Joicy Els Jojo
Department of General Surgery, MOSC Medical College, Kolenchery - 682 311, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ksj.ksj_14_22

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Background: Although multiple criteria are available for prognosis and determination of severity of acute pancreatitis (AP), there is a need to identify better predictors of developing complications. Arterial pH is a component of the APACHE-II scoring system, commonly used in AP. Aim: The aim of this article is to study the diagnostic accuracy of arterial pH, bicarbonate levels and base deficit in predicting morbidity and mortality in AP. Materials and Methods: A cross-sectional study (agreement analysis) was performed on inpatients with AP in a tertiary hospital. One hundred and forty patients based on clinical, biochemical and radiological findings were included in this study. Patients with AP following trauma/surgical intervention, tumours of pancreas and patients with age ≤18 years were excluded all categorical variables were summarised using frequency and percentage. All quantitative variables were summarised using mean and standard deviation sensitivity, specificity, positive predictive value and negative predictive value were estimated. Statistical analysis was performed using EZ R software. Results: All participants who required ventilatory support, haemodialysis or blood product transfusion had a pH of <7.35. 12/13 (92.3%) of patients who were on haemodynamic supports had bicarbonate levels <22mmol/L. Those who required respiratory support had bicarbonate level <22 mmol/L and base deficit <–4 mmol/L. 11/13 (84.6%) who required haemodynamic supports had base deficit <–4 mmol/L. All 5 of the 140 (3.57%) participants who expired had an arterial pH <7.35, bicarbonate level <22 mmol/L and base deficit <–4 mmol/L. Conclusion: In patients with AP, low arterial pH, low bicarbonate levels and high base deficit at presentation predict an adverse outcome with a higher frequency of organ failure and mortality.

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