An audit of the management of patients with acute pancreatitis against national standards of practice.
BACKGROUND
The aim of this study was to audit the management of patients with acute pancreatitis against the standards of practice in the British Society of Gastroenterology guidelines.


METHODS
The study assessed consecutive patients with acute pancreatitis over 5 years. Audit targets were overall mortality below 10 per cent, mortality for severe acute pancreatitis below 30 per cent, correct diagnosis and severity stratification within 48 h, aetiology determined in more than 80 per cent, availability of computed tomography and high-dependency or intensive therapy units when indicated and definitive treatment of gallstone pancreatitis within 2 weeks.


RESULTS
Of 759 patients with acute pancreatitis, 219 (28.9 per cent) had severe acute pancreatitis (SAP). Overall mortality was 5.9 per cent, and 19.6 per cent in those with SAP. Acute pancreatitis was diagnosed within 48 h of presentation in 96.3 per cent of patients. The definitive aetiology was classified in 87.5 per cent. Of patients with SAP, 95.9 per cent underwent computed tomography within 6-10 days of admission. Of 93 patients with severe gallstone pancreatitis, 48 per cent had urgent endoscopic retrograde cholangiopancreatography, and 89.6 per cent of 359 patients with acute gallstone pancreatitis underwent definitive management within 2 weeks of admission.


CONCLUSIONS
Patients with acute pancreatitis can be managed according to revised guidelines with a low associated mortality.
Mofidi
R
R
Department of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh UK.
Madhavan
K K
KK
Garden
O J
OJ
Parks
R W
RW
D018806:APACHE; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D017410:Practice Guidelines as Topic / Q000592:standards; D014057:Tomography, X-Ray Computed