EP 448 A Decade in Review: Outcomes and Management of Severe Acute Pancreatitis in a DGH
Neha Hande, Santhosh LoganathanAbstract
Aim
Acute severe pancreatitis (ASP) is increasingly common in the UK, with an incidence of about 56 per 100,000. Approximately 25% of acute pancreatitis cases become severe and involve organ failure. According to the literature, 1 in 4 severe cases is fatal, resulting in a mortality rate of 5% and highlighting the need for better management. We audited ASP patients in our trust and analysed various parameters to assess our outcomes as a DGH.
Methods
Data on patients with pancreatitis were collected retrospectively over 10 years (2015-2025). Patients aged 16 years or older with ASP, defined as persistent organ failure lasting more than 48 hours (Revised Atlanta Classification 2012), were included.
Results
Over 10 years, 154 patients were admitted with acute pancreatitis; 50 (32%) had severe disease. Males comprised 54%. BMI was 25–29 in 34% and 30–35 in 32%. Etiologies were gallstones (36%), idiopathic (28%), and alcohol (26%). On admission, 64% underwent imaging, 96% received antibiotics, and 78% required ITU care. A Glasgow score was calculated in only 52%. Mortality was 38%. Early complications occurred in 96% and late complications in 26%. Only 6 patients (12%) were transferred to tertiary care.
Conclusion
This audit demonstrates a high mortality rate and a significant burden of complications among patients with acute severe pancreatitis, highlighting mandatory early severity scoring, more judicious use of antibiotics, appropriate timing of imaging, prompt ITU involvement, and earlier transfer to tertiary centres to optimize outcomes in this high-risk population.