| Abstract [eng] |
The mortality rate of patients with severe acute pancreatitis (SAP) can reach up to 30%. Early and appropriate treatment will progress in reducing rates of SAP complications. The main problem remains, that neither prognostic scores nor single predictors can’t accurately predict the disease course and complications during the first hours of hospitalization. Perhaps, the least studied group of predictors are adipokines. Adipokines are cytokines produced in white adipose tissue as well as in peripancreatic fat and involved in inflammatory response. Increase of fatty tissue due to obesity is associated with the amplified systemic inflammatory response in AP. It is hypothesized that peripancreatic necrosis can cause the massive release of adipokines into the patient’s bloodstream, so adipokines can serve as predictors of clinical course and complications of acute pancreatitis. Furthermore, in 2012 the Atlanta classification of AP was revisited and new form – moderate severity AP – was indentified. Therefore the criteria of SAP became more stringent and the cut off values of all prognostic markers must be recalculated. The aim of the dissertation is to evaluate the prognostic usefulness of inflammation markers and compare it with existing prognostic systems for AP course and complications. The study enrolled 102 of AP patients. According to the revisited Atlanta classification 27 (26.5%) of all patients were classified as mild, 55 (53.9%) as moderate severity and 20 (19.6%) as SAP. It was found, that higher BMI and the peripancreatic necrosis are associated with more severe AP cases. Resistin, IL-6 and BISAP score were found to be the early markers of SAP. Only BISAP score was an early predictor of necrosis, needs for interventions and mortality. |
