KUMJ | VOL. 23 | NO. 5 | ISSUE 93 | DECEMBER, 2026

Clinical Outcomes of Patients with Acute Pancreatitis at a Tertiary Care Centre: Dhulikhel Hospital
Shrestha NM, Pathak S, Poudel P, Sapkota V, KC Pukar, Neupane S, Gurung RB

Abstract:
Background Acute pancreatitis (AP) is an inflammatory condition of the pancreas with a wide spectrum of severity, ranging from mild, self-limiting illness to severe disease with systemic complications and high morbidity. Objective To evaluate the clinical profile, etiology, severity, outcomes, and risk factors for complications in patients with acute pancreatitis admitted to a tertiary care center in Nepal. Method An observational cross-sectional study was conducted among 76 patients with acute pancreatitis admitted at Dhulikhel Hospital from December 2023 to November 2024 AD. Diagnosis were made based on the most recent revised Atlanta criteria 2012. Clinical, laboratory, and radiological data were collected. Severity classification, predictors of complications, and outcome measures including hospital stay, mortality, and late complications were analyzed using descriptive statistics for baseline characteristics, Chi-square test were applied to compare categorical and continuous variables, respectively. A p-value < 0.05 was considered statistically significant. Result The mean age was 47.72 ± 17.26 years, with a male predominance (53.9%). Alcohol (46%) and biliary causes (38%) were the most common etiologies. Based on the severity, 43.42% had mild AP, 46.05% had moderately severe acute pancreatitis and 10.52% had severe acute pancreatitis. C-Reactive Protein (CRP) was the most reliable severity marker (sensitivity 77.78%, specificity 96.88%). Acute Respiratory Distress Syndrome (ARDS) occurred in 87.5% of severe acute pancreatitis cases. Acute Kidney Injury (AKI) among acute pancreatitis was significantly associated with prolonged hospital stay (p < 0.001). Among 22 patients with peri-pancreatic fluid collection, 60% of those with severe acute pancreatitis developed late complications. Risk of developing late complications was higher in patients with Bedside Index for Severity in Acute Pancreatitis (BISAP) ≥ 2, hematocrit ≥ 44%, Body Mass Index (BMI) ≥ 25 kg per square meter, and Acute Kidney Injury. Conclusion Alcohol and biliary causes are the most common causes of acute pancreatitis in our population. C-Reactive Protein is a strong early marker of severity, while Acute Kidney Injury is a key determinant of hospital stay. Patients with severe acute pancreatitis, high Bedside Index for Severity in Acute Pancreatitis scores, or elevated hematocrit are more likely to develop late complications. Early risk stratification using simple markers can guide timely intervention and improve outcomes.
Keyword : Acute pancreatitis, Outcome measures, Tertiary care center