492 Raising the standards: management of acute pancreatitis in a district general hospital
Ahmed Nazari, Shifa Bangi, Aliaa Sharmadal, Arya Krishnan, Nicola Tanner- Surgery
Abstract
Introduction
Pancreatitis is a common condition seen in General Surgery which may cause significant morbidity and mortality. Current guidelines include fluid resuscitation, ABG and Glasgow-Imrie scoring every 48 hours. The aim of this study is to assess how well the current guidelines are being adhered to at NGH, identify the problems affecting patient care, and plan a sustainable solution.
Methods
57 of 102 admissions coded as pancreatitis between Jan-July 2022 fit the inclusion criteria. Information regarding adequate fluid prescription, usage of antibiotics, type of pancreatitis, Glasgow scoring and the type of pancreatitis was collected from patients’ paper and electronic records.
Results
Average length of stay was 8.3 days. 5 patients (8.8%) were necrotising and 13(22.8%) had concurrent cholecystitis. ABG was done in 14 (24.6%) patients. 17 (29.8%) had a Glasgow-Imrie score planned and 10 (17.5%) had a documented score. 55 (96.5%) patients were fluid resuscitated and all received adequate analgesia. 5 (8.8%) were admitted to ITU, 2 (3.5%) had critical care review. 3/5 (60%) of patients were scored prior to ITU admission. 13 (22.8%) had recurrent pancreatitis and 6 (10.5%) died.
Conclusion
The current management of pancreatitis at NGH could be improved. Scoring for pancreatitis severity helps early management of patient in need of ITU. We propose creating a pancreatitis pro-forma with scoring to be placed inside every patient's notes with a checklist for pancreatitis management and scoring.