A STUDY OF SERUM CALCIUM AND SERUM ALBUMIN LEVELS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS

Background:Acute Pancreatitis (AP) is an acute inflammatory process of the pancreas that affects other regional tissues and more distant organ system through the systemic inflammatory response , resulting in organ dysfunction and death. Only Minority patients will develop a severe disease , while most patients suffer from a mild ,self limiting inflammatory process.About 10 to 20% of patients will progress to Severe Acute Pancreatitis (SAP) with a mortality rate of 6 to 10 %. Serum calcium and serum albumin obtained within the first 24 hours of hospital admission are useful predictors of severity in Acute Pancreatitis . With an adequate interpretation of their cut-off points, they are valuable for identifying the patients that require intensive care support, even in primary and secondary care centers.So easily availaibilty of these laboratory investigation can be used for early assessment and treatment of severe Acute Pancreatitis(SAP) and therefore helps in reducing mortality due to Acute pancreatitis. we also compared and correlated other scoring system in predicting the severity of acute pancreatitis. Materials and Methods: We conducted a prospective observational study of serum calcium and serum albumin levels in predicting severity of acute pancreatitis. Data was collected from 100 inpatients over 18 months admitted to in-patient in Department of general Medicine,Basaveshwara Teaching and General Hospital attached to M.R Medical College, Kalaburgi .Data was analyzed using SPSS software version 26. Results: Total of 100 patients with 87 males and 13 females were enrolled. Among the 100 patients 31 patients developed Severe Acute Pancreatitis (SAP) marked by evidence of end organ failure, local complications like psuedocyst, and /or prolonged ICU stay of more than 7 days and 9 patients died. Among the individual parameters Serum Albumin, Serum calcium, Corrected serum calcium including TC (Total cell count), Serum Urea, ,Serum creatinine , Pao2 ,Serum LDH showed a significant association with severity of acute pancreatitis . APACHE II systems had a sensitivity of 71.10% and specificity of 96.67 % in predicting severity.Sensitivity and specificity of Ransons score was 77.42% and 96.56% respectively. BISAP score had a low sensitivity of 61.67% and high specificity 98.33% . Conclusion:APACHE II score and Ransons score are the best scoring systems in predicting the severity of acute pancreatitis. Parameters like Hypoalbuminemia, Hypocalcemia including Hypoxia,uremia, Acute renal failure, leukocytosis, and increase in serum LDH levels weresignificantly associated with Severe Acute Pancreatitis(SAP).