EWS in Predicting Severity of Acute Pancreatitis - An Early Guide for Clinician Working in Limited Facilities
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 7
Abstract
Introduction: Acute pancreatitis is fairly common and lethal condition, often associated with one or more complications in varying degree; demanding high index of suspicion, early diagnosis and aggressive individualized management, if morbidity and mortality has to be lowered. The purpose of this retrospective observational study was to quantify the SIRS response of the body in the form of Emergency Warning Score (EWS) and correlating it with the severity of Acute Pancreatitis (AP). Material and Methods: This retrospective study of 120 consecutive patients of diagnosed AP has been carried out in a hospital attached to a medical college. Patients admitted with first episode of acute pancreatitis, diagnosed as per Revised Atlanta Classification, 2012 are included. Recorded clinical data (respiratory rate, temperature, blood pressure, pulse rate, CNS status, urine output) within the first 24 hours of admission of each patient were used to calculate EWS on hourly bases. Then it was correlated individually with each patient’s disease severity they developed during the course of admission; to find if it has any role in predicting the disease severity. It was also correlated with the clinical progression of the disease in terms of favourable or unfavourable outcome. Results: It was observed that 60 patients with EWS ≥4 on the first day later developed moderate to severe AP. Of them 40 (66.67%) patients had unfavourable outcome with mortality in 16 (26.67%) patients. These patients had long duration (median 19 days) of hospital stay. Conclusion: EWS score≥4 on first day of admission can predict the disease severity and thus unfavourable outcome. No need of investigations (to predict the disease severity) and easy application makes EWS system a useful guide for clinician to anticipate progress of disease
Authors and Affiliations
Ronak Vyas, Kashyap Vyas
Keywords
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