Audit of acute pancreatitis management: a tale of two hospitals

Background: A case note audit of existing practices in the management of ac ute pancreatitis (AP) at a district general hospital (DGH) and a teaching h ospital was undertaken to determine if practices were in accordance with pu blished UK guidelines. Methods: Casenotes of all adults admitted with AP ov er a period of one year at the two hospitals were reviewed. Results: Ninety -five patients were treated for AP at the teaching hospital and 52 at the D GH. The age, sex and aetiological distributions at the two hospitals were s imilar. Fifteen (15.8%) patients at the teaching hospital and eight (15.3%) at the DGH had severe AP. Four patients died at each hospital. Prognostic Glasgow criteria tests (excluding LDH) were completed within 48 hours in 43 % patients at the teaching hospital and 48% at the DGH. Five of the twenty- five cholecystectomies at the teaching hospital and 4/18 at the DGH were pe rformed within four weeks after admission with AP. Conclusion: Audit of cur rent practice has highlighted deficiencies at many levels compared with cur rent evidence-based guidelines, although this has not resulted in unexpecte d mortality. It remains to be seen whether new measures to aid compliance w ith guidelines will result in improvement in morbidity and mortality.