Evaluation of Patients with Acute Pancreatitis in the Emergency Department

Abstract

Objective: The aim of this study was to assess the demographic and clinical features, diagnostic methods and outcomes of patients diagnosed as acute pancreatitis in the emergency department (ED). Materials and Methods: This study was designed retrospectively by examining medical records of the patients (age≥18 years) who were diagnosed as acute pencreatitis in the ED, between January 2007 and January 2008. Results: A total of 61 patients (31 male [50.8%], mean age 60,6±15,4) diagnosed as acute pancreatitis were enrolled the study. Nausea and abdominal pain were common complaints on admission. Clinical severity was mild in 32 patients (61.5%) and was severe in 20 patients (38.5%). CT severity index (CTSI) was determined in these patients. The sensitivity, specificity, positive predictive value, negative predictive value were calculated for the CTSI>3 (90%, 97%, 95%, 94%) for identifying the severe pancreatitis. Fifty patients (%82) were hospitalized. There was a correlation between duration of hospitalization and CTSI in these patients (p=0.001, r=0.497). Conclusion: Early identification of clinical severity is crucial for planning of therapeutic strategies of acute pancreatits in the ED. Abdomen CT is an effective method in the diagnosis, assessment of clinical severity and complications of acute pancreatitis.

Keywords

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Acil Serviste Akut Pankreatit Tanısı Alan Hastaların Değerlendirilmesi

Öz

Amaç: Bu çalışmanın amacı acil serviste (AS) akut pankreatit tanısı alan olguların demografik ve klinik özelliklerini, tanısal yaklaşımlarını ve klinik sonuçlarını tartışmaktır. Gereç ve Yöntemler: Ocak 2007 ve Ocak 2008 tarihleri arasında hastanemiz AS'inde akut pankreatit tanısı alan hastaların (yaş≥18) kayıtları geriye dönük olarak incelendi. Bulgular: Çalışmaya akut pankreatit tanısı alan 61 hasta (31 erkek [%50,8], ortalama yaş 60,6±15,4) dahil edildi. Başvuru anında karın ağrısı ve bulantı sık görülen şikayetler idi. Hastaların 32'sinde (%61,5) klinik hafif iken, 20'sinde (%38,5) şiddetli idi. Bu hastalarda BT şiddet skoru (BTŞS) değerlendirildi. BTŞS >3 değerinin şiddetli pankreatiti tanımadaki duyarlılık, özgüllük, pozitif öngörü değeri, negatif öngörü değeri sırasıyla (%90, %97, %95, %94) hesaplandı. Hastalardan 50'si (%82) hastaneye yatırılmıştı. Yatan hastaların BTŞS'si ile yatış süreleri arasında korelasyon mevcuttu (p=0.001, r=0.497). Sonuç: Acil serviste akut pankreatit tanısı alan hastalarda klinik şiddetin erken dönemde tanımlanması uygun tedavi stratejisinin belirlenmesine katkı sağlar. Batın BT akut pankreatit tanısında, klinik şiddetin ve komplikasyonların belirlenmesinde etkili bir yöntemdir.

Anahtar Kelimeler

• Akut pankreatit, acil servis, BT şiddet skoru

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