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ORIGINAL ARTICLE
Year : 2022  |  Volume : 28  |  Issue : 1  |  Page : 44-48

Prevalence of multi-organ dysfunction syndrome amongst patients with acute pancreatitis


Department of General Surgery, Government Medical College, Thiruvananthapuram, Kerala, India

Correspondence Address:
Dr. Thulasi Bhai Amma Preethi
Department of General Surgery, Medical College, Thiruvananthapuram - 695 011, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ksj.ksj_19_22

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Background: Approximately 20% of patients with acute pancreatitis (AP) develop multi-organ dysfunction syndrome (MODS). Factors which determine the severity of pancreatitis and the development of MODS are multiple and early identification may lower the morbidity and mortality. The Sequential Organ Failure Assessment (SOFA) scoring system has been shown to measure disease severity. The objectives of this study were to estimate the prevalence of MODS amongst patients with AP and to assess the factors associated with it. Methodology: All selected consecutive cases were interviewed for relevant history. Physical examination was done, and blood samples were tested. The prevalence of MODS amongst the patients was assessed using the SOFA scoring system, and the proportion of organ involvement was assessed. Several physical and aetiological factors and laboratory parameters were compared in those with and without MODS. Values were analysed using Chi-square test in SPSS. Results: Out of the 238 patients included, 46 (19.3%) developed MODS. There were 217 males and 21 females. Using SOFA scoring system score MODS, the most commonly involved organs were the liver (26%) and kidney (18%). Majority of MODS patients were elderly (age > 40 years; P = 0.014) and male sex (P = 0.004). Smoking (P = 0.015), hypertriglyceridaemia (P = 0.001), pancreatic cancer (P = 0.019) and body mass index (BMI) (P = 0.006) had a statistically significant relation. Serum amylase and lipase, total leucocyte count, serum C-reactive protein (CRP), lactate dehydrogenase (LDH) and erythrocyte sedimentation rate (ESR) also had statistically significant relation (P < 0.001). The mean serum amylase value in those with MODS was 4027.9U/L, serum lipase was 6168.9 IU/L, mean leucocyte count was 17,449.1 cells/mm3, serum CRP value was 5.7 mg/L, mean ESR was 36 mm/h and serum LDH was 600.7 IU. Conclusions: Pancreatic cancer and BMI had significant relation with MODS in AP. Biochemical markers such as serum amylase, Serum lipase, serum LDH, serum CRP, total leucocyte count and ESR had significant predictive value in detecting MODS in AP.


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