Jayas Siby1, Preetha S.2, Sindhu R.S.3
BACKGROUND
Acute pancreatitis is a very common disease and severe acute pancreatitis is life
threatening and needs early identification. Current severity predicting indices in
acute pancreatitis are cumbersome. There have been previous reports of low HDL
cholesterol in life threatening acute pancreatitis. Previous studies in this regard
were done in a single ethnicity population and needed to be validated in other
ethnic groups. We wanted to estimate the proportion of pancreatic necrosis among
the patients with acute pancreatitis attending Government Medical College,
Thiruvananthapuram. We also wanted to compare the mean HDL values in those
who developed pancreatic necrosis and those who didn’t develop pancreatic
necrosis and evaluate the association between HDL value measured 48 – 72 hours
of onset of symptoms and pancreatic necrosis.
METHODS
This was a prospective observational study conducted among 271 patients
diagnosed with acute pancreatitis in Government Medical College Hospital,
Thiruvananthapuram. Consecutive sampling method was used.
RESULTS
There were 42 cases of pancreatic necrosis out of 271 cases. The mean HDL of
those patients with pancreatic necrosis was found to be less than those without
necrosis (P < 0.001). Mean HDL value among those having pancreatic necrosis
was 17.7 whereas those without necrosis was 34.9.
CONCLUSIONS
Proportion of pancreatic necrosis was 15.5 %. The mean HDL measured at 48
hours of symptom onset among the necrotising pancreatitis patients was
significantly low when compared to the non-necrotic group (17.7 vs 34.9). All the
patients with pancreatic necrosis had their HDL less than 40. Thus, an inference
that low HDL at 48 hours of symptom onset was associated with higher incidence
of pancreatic necrosis and severe pancreatitis could be made.
