際際滷

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TheCompletionOfDiagnositicSerumAmylase
ForPatientsPresentingWithAcuteAbdominalPain
Aim
Toevaluatethee鍖ciencyofthecompletionofserumamylaselevelsasadiagnosticinvestigationforallpatientsadmittedunderthegeneral
surgicalteampresentingwithacuteabdominalpain
-AcutePancreatitisisacommonsurgicalemergency,accountingfor
3%ofthegeneralsurgicaltake
-Promptrecognitionanddiagnosisofpancreatitisiskeytogoodpatient
care
-25%developsevereoflifethreateningcomplicationsrequiringhigher
levelcare
--Mortalityrate6-10%;decreasingratesduetopromptdiagnosisand
improvingcriticalcaresupport
-Serumamylaseisareadilyavailablelaboratorytestusedtodiagnose
acutepancreatitis
-Serumamylaselevel3timesupperlimitofnormalisdiagnostic
Method
-Prospectivedatacollectionofclinicalnotesandelectronicbiochemical
results
-Datacollectionovera4weekperiod(1/6/14-30/6/14)
-Allreferralsourcestothegeneralsurgicalteam
fromGP,A+Eandotherspecialties)
-Allpatientsunder65yearsofagepresentingwith
localisedrightiliacfossapainwereexcludedfromthecohort
Diagnoses:
Results
Conclusion Recommendations
Serumamylaselevelsshouldbecompletedaspartofa
routineassessmentofallpatientspresentingwithacute
abdominalpain.
Themeasurementofserumamylase,inpatientsadmittedwith
abdominalpain,couldbesignicantlyimprovedinthetrust.
Increasedawarenessofbothreferringandacceptingteams
viapresentationsandposters
Re-audit6monthstime
1.TohSK,PhillipsSandJohnsonCD.AprospectiveauditagainstnationalstandardsofthepresentationandmanagementofacutepancreatitisintheSouthofEngland.Gut.2000;46:239-43.
2.NEOPTOLEMOSJP,RARATYM,FINCHMandSUTTONR.Acutepancreatitis:thesubstantialhumanand nancialcosts.Gut.1998;42:886-91.
3.O'ReillyDAandKingsnorthAN.Managementofacutepancreatitis.BMJ.2004;328:968-9.
4.KingsnorthAandO'ReillyD.Acutepancreatitis.BMJ.2006;332:1072-6.
5.StanilandJR,DitchburnJandDeDombalFT.Clinicalpresentationofacuteabdomen:studyof600patients.Britishmedicaljournal.1972;3:393-8.
6.6.BugliosiTF,MeloyTDandVukovLF.Acuteabdominalpainintheelderly.Annalsofemergencymedicine.1990;19:1383-6.
7.WinsletM,HallC,LondonNJandNeoptolemosJP.Relationofdiagnosticserumamylaselevelstoaetiologyandseverityofacutepancreatitis.Gut.1992;33:982-6.
8.LankischPG,Burchard-ReckertSandLehnickD.Underestimationofacutepancreatitis:patientswithonlyasmallincreaseinamylase/lipaselevelscanalsohaveordevelopsevereacute
pancreatitis.Gut.1999;44:542-4.
了族=13.8,p=0.001,df=1
Itisstatisticallysignicantthatnotallpatientsadmittedwithabdominalpainhadamylaselevelsdone

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