KHẢO SÁT ĐẶC ĐIỂM LÂM SÀNG, HÌNH ẢNH CHỤP CẮT LỚP VI TÍNH VÀ MỐI LIÊN QUAN CỦA MỘT SỐ YẾU TỐ TIÊN LƯỢNG Ở BỆNH NHÂN VIÊM TỤY CẤP TẠI BỆNH VIỆN NGUYỄN TRI PHƯƠNG

Abstract

Objective: This study investigates the clinical characteristics, computed tomography (CT) imaging features, and correlations of several prognostic factors with the severity of AP at Nguyen Tri Phuong Hospital. Methods: This retrospective cross-sectional study included patients diagnosed with AP from May 2021 to May 2024 at the General Surgery, Gastroenterology, and Internal Medicine departments. Data on clinical symptoms, laboratory tests, causes, abdominal CT results, severity classification according to the Atlanta criteria 2012, and prognostic scoring systems were collected. Statistical analysis identified correlations between factors and AP severity. Results: A total of 102 patients were included, with a mean age of 47.42 ± 15.11 years; 67.6% were male and 32.4% female. The main symptom was acute epigastric pain (100%), followed by vomiting (52%) and abdominal distension (18.6%). Serum amylase levels increased more than three times the upper limit in 74.2% of cases. Common causes of AP included alcohol (46.7%), diabetes (26.5%), smoking (25.5%), hypertension (16.7%), medication (5.9%), and hypertriglyceridemia (18.3%). On CT, 30.8% of patients showed pancreatic necrosis, and pleural effusion was detected in 11.7%. According to the Atlanta classification 2012, the rates of mild, moderate, and severe AP were 70.8%, 20.8%, and 8.4%, respectively. The severe AP group had higher rates of heart rate ≥ 110 beats per minute (66.7% vs. 10.8%), hypotension (50.0% vs. 5.4%), and pleural effusion on CT (70.0% vs. 18.8%) compared to the non-severe group (p < 0.01). The mean procalcitonin level at admission in the severe group was significantly higher than in the mild/moderate group (15.2 ng/mL vs. 2.8 ng/mL, p = 0.03). Body temperature and CRP levels at admission did not differ between groups. Conclusion: Epigastric pain with vomiting is common in AP patients. The primary causes of AP in our hospital are alcohol abuse, diabetes, smoking, hypertension, medication use, and hypertriglyceridemia. CT imaging is crucial for diagnosis and detecting complications (pancreatic necrosis, effusions, etc.). The rate of severe AP is approximately 6.9%. Early prognostic factors associated with severe AP include tachycardia ≥ 110 beats per minute, hypotension, systemic inflammatory response syndrome (SIRS), BISAP score, and hematocrit.