The laboratory parameters and scoring systems used to predict clinical outcomes in geriatric patients with acute pancreatitis

A.E. Kayipmaz, S. Gedikaslan, R.F. Aydogan

Department of Emergency, Ankara Etlik City Hospital, Ankara, Turkey. afsinemre.kayipmaz@saglik.gov.tr

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• Geriatrics

OBJECTIVE: Acute pancreatitis (AP) is the leading cause of hospital admissions among gastrointestinal system disorders, and it can resolve independently or lead to life-threatening multiple organ failure. Acute pancreatitis can have a more severe clinical presentation in geriatric patients as compared to younger patients. In this study, we aimed to elucidate the clinical and laboratory characteristics of patients aged 65 and older who presented to the emergency department with a diagnosis of AP and assessed their impact on hospital stay, in-hospital mortality, and cost.

PATIENTS AND METHODS: We reviewed the records of patients aged 65 and older who presented to the emergency department and had lipase levels measured as exceeding three times the upper limit of the reference range during the evaluation. We recorded these patients’ vital signs, medical histories, laboratory values, and etiologies. Using these data, we calculated the patients’ clinical scores.

RESULTS: We recorded data on 218 patients who met the inclusion criteria. The median age of the patients was 76 (65-113). Of these, 70.6% were females, 54.6% had gallstones, 90.4% (n = 197) were admitted to the general ward from the emergency department, and 7.3% (n = 16) were admitted to the intensive care unit (ICU). In-hospital mortality was 5.63% (n = 12). The Ranson, Glasgow Severity Score (GSS), and Bedside Index for Severity in Acute Pancreatitis (BISAP) scores, as well as lactate, procalcitonin, and the lymphocyte-albumin ratio, were independent predictors of ICU admission and mortality.

CONCLUSIONS: The early diagnosis of AP is essential. When a severe disease course is likely, initiating treatment promptly becomes crucial, especially in patients aged 65 and older. This approach can lead to significant reductions in both complication rates and treatment costs.

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