Prognostic Factors and Clinical Outcomes in Patients with Acute Pancreatitis: A Prospective Observational Study
DOI:
https://doi.org/10.61919/jhrr.v5i9.1954Keywords:
Acute pancreatitis, BISAP, pancreatic necrosis, prognostic factors, disease severity, prospective observational study.Abstract
Background: Acute pancreatitis is a common gastrointestinal emergency with a highly variable clinical course ranging from mild self-limiting inflammation to severe disease with organ failure, pancreatic necrosis, and death. Early identification of prognostic factors is essential for timely risk stratification and optimized management. Objective: To evaluate prognostic factors and clinical outcomes in patients with acute pancreatitis admitted to a tertiary care hospital. Methods: This prospective observational study was conducted at Fatima Memorial Hospital, Lahore, Pakistan, and included 22 adult patients diagnosed with acute pancreatitis. Demographic characteristics, etiological factors, clinical presentation, laboratory findings, BISAP scores, disease severity according to the Revised Atlanta Classification, complications, and in-hospital outcomes were recorded and analyzed. Associations between prognostic variables and outcomes were assessed using Chi-square or Fisher’s exact tests, with odds ratios and 95% confidence intervals calculated where appropriate. Results: Gallstone-related pancreatitis was the most common etiology (45.5%). Mild, moderately severe, and severe pancreatitis were observed in 54.5%, 27.3%, and 18.2% of patients, respectively. Higher BISAP scores were significantly associated with greater disease severity (p=0.001). Pancreatic necrosis was strongly associated with ICU admission (75.0% vs 11.1%; p=0.024) and severe pancreatitis (75.0% vs 5.6%; p=0.010). One patient died, yielding an in-hospital mortality rate of 4.5%. Conclusion: BISAP score and pancreatic necrosis were important prognostic indicators of adverse clinical outcomes in acute pancreatitis. Early bedside risk stratification may facilitate timely recognition of high-risk patients and improve hospital-based management. Keywords: Acute pancreatitis, BISAP, pancreatic necrosis, prognostic factors, disease severity, prospective observational study.
Downloads
References
Buxbaum J, Quezada M, Chong B, Gupta N, Yu CY, Lane C, et al. The Pancreatitis Activity Scoring System predicts clinical outcomes in acute pancreatitis: findings from a prospective cohort study. Am J Gastroenterol. 2018.
Ak Ç, Kahraman R, Sayar S, Kiliç E, Adalı G, Ozdil K. Prediction of prognosis acute pancreatitis with inflammatory markers and patient characteristics compared to the scoring system: real-life data. Sisli Etfal Hastan Tip Bulteni. 2023.
Silva-Vaz P, Abrantes AM, Morgado-Nunes S, Castelo-Branco M, Gouveia A, Botelho MF, et al. Evaluation of prognostic factors of severity in acute biliary pancreatitis. Int J Mol Sci. 2020;21(12):4300.
Mederos MA, Reber HA, Girgis MD. Acute pancreatitis. JAMA. 2021;325(4):382.
Jiang X, Su Z, Wang Y, Deng Y, Zhao W, Jiang K, et al. Prognostic nomogram for acute pancreatitis patients: an analysis of publicly electronic healthcare records in intensive care unit. J Crit Care. 2019;50:213-20.
Li X, Guo X, Ji H, Niu J, Gao P. Relationships between metabolic comorbidities and occurrence, severity, and outcomes in patients with acute pancreatitis: a narrative review. Biomed Res Int. 2019.
Moran R, Moran RA, García-Rayado G, Iglesia-García D, Martínez-Moneo E, Fort-Martorell E, et al. Influence of age, body mass index and comorbidity on major outcomes in acute pancreatitis, a prospective nation-wide multicentre study. United European Gastroenterol J. 2018.
Rostropowicz-Honka A, Klinger M. Type 2 diabetes and chronic kidney disease as important prognostic factors in acute pancreatitis. Postepy Hig Med Dosw. 2019.
Para O, Caruso L, Savo MT, Antonielli E, Blasi E, Capello F, et al. The challenge of prognostic markers in acute pancreatitis: internist’s point of view. J Genet Eng Biotechnol. 2021.
Tran A, Fernando SM, Rochwerg B, Inaba K, Bertens KA, Engels PT, et al. Prognostic factors associated with development of infected necrosis in patients with acute necrotizing or severe pancreatitis—a systematic review and meta-analysis. J Trauma Acute Care Surg. 2021;92(5):940-8.
Sundararajan K, Schoeman T, Hughes L, Edwards S, Reddi B. Predictors and outcomes of acute pancreatitis in critically ill patients presenting to the emergency department of a tertiary referral centre in Australia. Emerg Med Australas. 2017;29(2):184-91.
Tan JW, Gao Y, Kow AWC, Bonney G, Madhavan K, Windsor JA, et al. Clinical management and outcomes of acute pancreatitis: identifying areas for quality improvement in a tertiary Asian setting. Pancreatology. 2019;19(4):507-18.
Sternby H, Bolado F, Canaval-Zuleta HJ, Marra-López C, Hernando-Alonso A, del-Val-Antoñana A, et al. Determinants of severity in acute pancreatitis: a nation-wide multicenter prospective cohort study. Ann Surg. 2019.
Yang Q, Gao Y, Li Z, Zheng J, Fu H, Ma Y. Analysis of risk factors for severe acute pancreatitis in the early period (<24 h) after admission. J Emerg Med. 2024.
Qin X, Xiang S, Li W. Analysis of factors influencing onset and survival of patients with severe acute pancreatitis: a clinical study. Immun Inflamm Dis. 2024.
Agarwala R, Rana S, Sharma R, Kang M, Gorsi U, Gupta R. Gastrointestinal failure is a predictor of poor outcome in patients with acute pancreatitis. Dig Dis Sci. 2019.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Junaid Imtiaz, Kashif Zeeshan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Public Licensing Terms
This work is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). Under this license:
- You are free to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material) for any purpose, including commercial use.
- Attribution must be given to the original author(s) and source in a manner that is reasonable and does not imply endorsement. If changes were made to the material, this must be indicated.
- No additional restrictions may be applied that conflict with the terms of this license.
For more details, visit: https://creativecommons.org/licenses/by/4.0/
