ThP5.3 - A Clinical Audit on Assessing Severe Acute Pancreatitis: Improving the use of the Glasgow-Imrie Criteria and outcomes

Abstract Introduction Severe acute pancreatitis (SAP) is defined by pancreatic and extra-pancreatic necrosis, ITU admission, multisystem organ failure and death. Severity should be predicted on admission using the Glasgow-Imrie Criteria (GIC) to stratify patients and scores ≥ 3 are indicative of SAP and requires review by a senior and/or HDU/ITU to determine possible transfer to HDU/ITU. Methods We performed a 2-cycle audit on the use of the GIC to score 140 patients with acute pancreatitis (AP) from November 2022 – October 2023. Initial interventions included a presentation, posters and an email. The second intervention was the insertion of a scoring tick box into the electronic clerking notes. Results At baseline 44% (22/50) of patients with AP were scored using the GIC. Post first intervention this was 66% (21/32), post second intervention it was 84% (49/58). Post interventions the proportion of patients scoring ≥3 escalated to a senior and/or HDU/ITU increased from 17% to 100% and mean length of stay reduced from 14.5 to 11 days, also the completeness of documentation rose from 78% to 96%. There were 18 Glasgow-Imrie scores ≥ 3 and 8 of these patients developed clinical SAP. Conclusion Our audit showed that simple interventions and incorporation of the scoring system into the electronic notes increased the percentage of patients being scored on admission and resulted in all patients with a score ≥ 3 being reviewed by a senior and/or HDU/ITU. Incorporating the scoring into the electronic clerking document was relatively straightforward and could be adopted by other Trusts.