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Abstract Aim This study sought to evaluate compliance with NICE guidelines for assessing and managing acute pancreatitis at a district general hospital, following the implementation of a trust protocol designed to align with these guidelines; with a specific emphasis on initial interventions and Glasgow-Imrie scoring. Method A retrospective review of 102 patient admissions from January to October 2023 was conducted. Adherence to initial management protocols, as per NICE guidelines, was scored out of 6; covering fluid resuscitation, analgesia, nutritional support, causal investigations, imaging for suspected complications, and correct antibiotic use. Each patient’s Glasgow-Imrie score on admission was also calculated. Results Out of the 102 patient admissions analysed, 9.80% had a Glasgow-Imrie score ≥3, indicative of severe pancreatitis. Among these cases, there was on average a 96.67% adherence rate to NICE-recommended treatments, compared to 88.41% for less severe cases. Suboptimal practices were identified in antimicrobial prescriptions, with 23.54% administered incorrectly as prophylaxis. Additionally, 25.49% of patients were made nil-by-mouth without an alternative nutrition plan. Furthermore, deficiencies were noted in components necessary for Glasgow-Imrie scoring, with only 11.76% and 22.55% of patients having a measured PaO2 and LDH, respectively. Conclusions While this study demonstrates a commitment to evidence-based management in severe acute pancreatitis, identified variations in guideline application for more moderate cases emphasise the need for targeted educational interventions, particularly in antimicrobial prescribing and providing nutritional support. Ensuring adherence to often-overlooked parameters (LDH, PaO2) in the Glasgow-Imrie scoring system is crucial for a more accurate assessment of severity, thereby facilitating appropriate and effective management for these patients.
Mushtaq et al. (Mon,) studied this question.