Investigation of the relationship of body fluid volume, which is assessed by measuring vena cava inferior and aortal diameter with USG in patients with the diagnosis of acute pancreatitis in the emergency department with the duration of the hospital and mortality

Objective: Acute pancreatitis is the most common gastrointestinal disease requiring acute admission to hospital in developed countries. It is a disease that can cause fluid extravasation in the third space and can result in hypovolemia, hypoperfusion, organ failure and eventually death. There is no gold standard scale and/or test used to determine the hospitalization, duration of discharge and mortality risk of patients admitted to the emergency department with acute pancreatitis. In recent years, sonographic assessment of inferior vena cava (IVC) diameter to assess intravascular volume status and guide fluid resuscitation has gained popularity in emergency departments. In our study, we aimed to investigate the effects of IVC and aortic diameter imaging on hospitalization, discharge and mortality in patients admitted to the emergency department with acute pancreatitis. Materials and Methods: Eighty-three patients with acute pancreatitis diagnosed between 01/01/2021 and 01/03/2021 were included in this study. Inferior vena cava (IVC) and aortic diameters of the patients were prospectively recorded using ultrasonography (USG). Demographic and clinical characteristics, laboratory and imaging reports of the patients were also recorded. The hospitalization status, duration of hospitalization and survival status of the patients within 30 days were monitored through the system. The data obtained were statistically analyzed by dividing them into different groups according to the mortality status within 30 days, collapsibility index (CI) and hospitalization status. Results: The median age of the patients who died within 30 days was found to be higher than the survivors (p = 0.004), but when the CI and aortic diameters were compared between these two groups, no statistically significant difference was found. BISAP ((The Bed Side Index for Severity in Acute Pancreatitis) and Glasgow-IMRIE scores used in acute pancreatitis were found to be associated with mortality (p = 0.001 and p = 0.04). A positive correlation was found between CI and duration of hospital stay in surviving patients (r2 = 0.37 and p = 0.001). At the same time, when the patients were divided into two groups according to their CI, it was observed that the duration of hospital stay increased in the group with a high index (p <0.05). IVC (ins) diameter measurements were found to be lower in patients hospitalized in intensive care unit compared to patients hospitalized in the service (p = 0.04). Conclusion: It was observed that IVC diameter (ins-exp), CI and aortic diameter, which reflect the intravascular fluid status of the patients and can be determined by USG, have no effect on predicting mortality. However, our results showed that CI can be useful in predicting length of stay in hospital and IVC (ins) diameter to predict service-intensive care admission status. Keywords: Acute pancreatitis, vena cava infeior diameter, aortic diameter, vena cava collapsibility index, mortality