Register for email alerts and news feeds:
This journal | BMJ Group
rss
Gut 2000;46:239-243; doi:10.1136/gut.46.2.239
Copyright © 2000 BMJ Publishing Group Ltd & British Society of Gastroenterology.
Gut 2000;46:239-243 ( February )

Article

A prospective audit against national standards of the presentation and management of acute pancreatitis in the South of England S K C Toh, S Phillips, C D Johnson

University Surgical Unit (816), Southampton General Hospital, Tremona Rd, Southampton, Hampshire SO16 6YD, UK

Correspondence to: Mr Johnson.

Accepted for publication 9 September 1999

BACKGROUND---The incidence of acute pancreatitis shows regional variations in the UK.
AIMS---To document the incidence and presentation of acute pancreatitis in hospitals in Wessex, and to audit the process and outcome of management of patients against the UK guidelines.
METHODS---A prospective survey was carried out of all patients with acute pancreatitis in a one year period, in eight geographically adjacent acute hospitals in the Wessex region.
RESULTS---186 patients with acute pancreatitis were identified, an incidence of 152 per million in the adult population. Aetiology was: gallstones 33%, alcohol 20%, idiopathic 32%, other 15%. There were 60 severe cases with 17 deaths. Age and APACHE-II score had significant relations to outcome, but delay to admission, serum amylase level, aetiology, and sex did not. The mortality rate (9.1%) was within the audit standard of 10%. Some management goals were not met: in mild cases, only one third of patients with gallstone pancreatitis had definitive treatment within four weeks. In severe cases, there was poor use of objective severity stratification (19%), low admission rates to a high dependency unit or intensive care unit (67%), and only 33% of patients had computed tomography. Only seven of 17 patients with severe gallstone pancreatitis had an urgent endoscopic retrograde cholangiopancreatography.
CONCLUSIONS---The incidence of clinically diagnosed acute pancreatitis in England continues to rise. Current management of acute pancreatitis is suboptimal when compared with evidence based UK guidelines but the mortality rate was within the guideline standard.


Keywords: acute pancreatitis; epidemiology; management; audit


© 2000 by Gut

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

This article has been cited by other articles:

  • Williams, J G, Roberts, S E, Ali, M F, Cheung, W Y, Cohen, D R, Demery, G, Edwards, A, Greer, M, Hellier, M D, Hutchings, H A, Ip, B, Longo, M F, Russell, I T, Snooks, H A, Williams, J C (2007). Gastroenterology services in the UK. The burden of disease, and the organisation and delivery of services for gastrointestinal and liver disorders: a review of the evidence. Gut 56: 1-113 [Full Text]  
  • Matull, W R, Pereira, S P, O'Donohue, J W (2006). Biochemical markers of acute pancreatitis.. J. Clin. Pathol. 59: 340-344 [Abstract] [Full Text]  
  • UK Working Party on Acute Pancreatitis, (2005). UK guidelines for the management of acute pancreatitis. Gut 54: iii1-iii9 [Full Text]  
  • Johnson, C D, Abu-Hilal, M (2004). Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis. Gut 53: 1340-1344 [Abstract] [Full Text]  
  • Goldacre, M. J, Roberts, S. E (2004). Hospital admission for acute pancreatitis in an English population, 1963-98: database study of incidence and mortality. BMJ 328: 1466-1469 [Abstract] [Full Text]  
  • Flint, R., Windsor, J. A. (2004). Early Physiological Response to Intensive Care as a Clinically Relevant Approach to Predicting the Outcome in Severe Acute Pancreatitis. Arch Surg 139: 438-443 [Abstract] [Full Text]  
  • Erb, N., Duncan, R. C., Raza, K., Rowe, I. F., Kitas, G. D., Situnayake, R. D. (2002). A regional audit of the prevention and treatment of corticosteroid-induced osteoporosis in patients with rheumatic diseases in the West Midlands. Rheumatology (Oxford) 41: 1021-1024 [Abstract] [Full Text]  
  • Lempinen, M., Kylanpaa-Back, M.-L., Stenman, U.-H., Puolakkainen, P., Haapiainen, R., Finne, P., Korvuo, A., Kemppainen, E. (2001). Predicting the Severity of Acute Pancreatitis by Rapid Measurement of Trypsinogen-2 in Urine. Clin. Chem. 47: 2103-2107 [Abstract] [Full Text]  

This Article

Services
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

Cardiology Jobs

Gastroenterology Jobs