ROLE OF BIOCHEMICAL PARAMETERS IN MORTALITY PREDICTION IN PATIENTS DIAGNOSED WITH ACUTE PANCREATITIS IN A TERTIARY CARE.
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Keywords
Bicohemical parameters, mortality prediction, Acute pancreatitis, tertiary care.
Abstract
Acute pancreatitis (AP) is a common gastrointestinal emergency with significant morbidity and mortality. Early identification of patients at risk of adverse outcomes remains challenging. Biochemical parameters are readily available, cost-effective investigations that may aid in early risk stratification and mortality prediction.
Objectives: To evaluate the role of selected biochemical parameters in predicting in-hospital mortality among patients diagnosed with acute pancreatitis in a tertiary care setting.
Methods: This prospective observational study was conducted over a two-year period (August 2022–September 2023) and included 100 adult patients diagnosed with acute pancreatitis based on the Revised Atlanta Classification 2012. Demographic data, etiological factors, disease severity, and clinical outcomes were recorded. Biochemical parameters assessed at admission included hematocrit, blood urea nitrogen (BUN), serum procalcitonin, serum amylase, serum lipase, serum C-reactive protein (CRP), arterial blood gas parameters (pH, PaO₂, PaCO₂), and neutrophil–leukocyte ratio (NLR). The Bedside Index for Severity in Acute Pancreatitis (BISAP) score was calculated within the first 24 hours. Biochemical parameters were compared between survivors and non-survivors. ROC curve analysis was performed to identify independent predictors of mortality.P <0.05 cosidered as statistically significant.
Results: The mean age of the study population was 37.25 ± 7.3 years, with a male predominance (59%). In-hospital mortality was observed in 7% of patients. Non-survivors had significantly higher hematocrit (48.7 ± 6.4%), BUN (54.3 ± 11.6 mg/dL), serum procalcitonin (6.8 ± 3.1 ng/mL), CRP (268 ± 74 mg/L), pancreatic enzyme levels, and NLR (18.9 ± 6.5), along with lower arterial pH and PaO₂ (p < 0.05). ROC analysis demonstrated excellent predictive performance of NLR, serum procalcitonin, BUN, and CRP. Multivariate logistic regression identified elevated NLR, increased serum procalcitonin, raised BUN, high CRP levels, and metabolic acidosis as independent predictors of mortality.
Conclusion: Routinely available biochemical parameters play a crucial role in early prognostication and mortality prediction in acute pancreatitis. Their integration into routine clinical assessment can aid in timely risk stratification, guide management decisions, and improve patient outcomes, particularly in resource-limited tertiary care settings.
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Dr Pallavi Ashrit
Professor, Department of Biochemistry, Navodaya Medical College, Raichur, Karnataka.
Dr Netravathi B Sajjan
Associate professor, Department of Biochemistry,Navodaya Medical College, Raichur, Karnataka.
Dr Rajeshwari Patil
Assistant professor, Department of BiochemistryBidar institute of medical science, Bidar.
Dr Girish M Desai Dr
Professor and HOD, Department of Biochemistry, Gulbarga Institute of Medical sciences, Kalaburagi 585105 , Karnataka.
