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. 2017:2017:3525349.
doi: 10.1155/2017/3525349. Epub 2017 Apr 13.

Severity, Treatment, and Outcome of Acute Pancreatitis in Thailand: The First Comprehensive Review Using Revised Atlanta Classification

Supot Pongprasobchai  1 , Peeradon Vibhatavata  2 , Piyaporn Apisarnthanarak  3
Affiliations

Severity, Treatment, and Outcome of Acute Pancreatitis in Thailand: The First Comprehensive Review Using Revised Atlanta Classification

Supot Pongprasobchai et al. Gastroenterol Res Pract. 2017.

Abstract

Background. Severity and outcome of acute pancreatitis (AP) in Thailand are unknown. Methods. A retrospective study of 250 patients with AP during 2011-2014 was performed. Severity, treatment, and outcome were evaluated. Severity was classified by revised Atlanta classification. Results. The mean age was 58 years and 56% were men. Etiologies were gallstones (45%), alcohol (16%), postendoscopic retrograde cholangiopancreatography (14%), and idiopathic (15%). Overall, 72%, 16%, and 12% of patients had mild, moderately severe, and severe AP, respectively. Two major types of initial intravenous fluid were normal saline (64%) and Ringer's lactate solution (RLS, 28%). Enteral nutrition was given in 77% of patients with severe AP, median duration 48 hours, and via a nasogastric tube in 67% of patients. Necrotizing pancreatitis (NP) developed in 7% of patients, and 29% of them developed infection (median 17 days). The median length of stay was 6, 9, and 13 days, and the mortality rate was 1%, 3%, and 42% in mild, moderately severe, and severe AP, respectively. The overall mortality rate was 6%. Conclusion. The severity of AP in Thailand was mild, moderately severe, and severe in 72%, 16%, and 12% of patients, respectively. NP was not prevalent. Mortality was high in severe AP. Most treatments complied with standard guidelines except the underuse of RLS.

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Figures

Figure 1
Figure 1
Severity of acute pancreatitis.
Figure 2
Figure 2
Types and amounts of intravenous fluid therapy during the first 24 hours. NSS, normal saline solution; RLS/RAS, Ringer's lactate solution/Ringer's acetate solution.
Figure 3
Figure 3
Routes of enteral nutrition. NG, nasogastric; NJ, nasojejunal.
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