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Since 50% of the mortalities in acute pancreatitis (AP) occur within the first week, early prediction f its outcomes is vital. The CT severity index (CTSI) rel iably predicts outcomes when calculated 4-7 days af ter onset. However, a therapeutic window for early aggressive int rvention is lost. The Balthazar score can be ca lcul ted within 48 hours of onset, thus being a diagnostic as well as a prognostic investigation. Omega-3 polyunsaturated fatty acids ( ω-3 PUFA) have a beneficial immunomodulatory effect and improve outcomes in AP. Materials and Methods: 80 patients of clinically predicted severe acute pancreatitis w ere included. Treatment group received IV ω-3 PUFA supplementation. Balthazar scores were calculated for all patients w i hin 48 hours of onset. Positive predictive value (PPV) for progression to severe acute pancreatitis (SAP) was calculated f rom the control group. The number of patients predi ct to progress to SAP was compared those actually progressing to SAP in the ω-3 PUFA group. Results: PPV for Balthazar score of D and above for predicting progression to SAP was 87. 5% in the control group. 35 (87.5%) patients were p dicted to progress to SAP in the ω-3 PUFA group, but only 28 (70%) patients progresse d to SAP (p=0.0315). Conclusion: Balthazar grade of D and above on a CT scan done wi thin 48 hours of onset of acute pancreatitis can ac curately predict the progression of clinically suspected severe acut e pancreatitis to severe acute pancreatitis. IV ω-3 PUFA supplementation early in the course of acute pancre titis significantly improves early clinical outcom es.

international journal of medical research and review

Assessment of efficacy of IV ω-3 PUFA supplementation in patients of predicted severe acute pancreatitis using the positive predictive value of Balthazar score within 48 hours of onset