CLINICAL AND PROGNOSTIC CHARACTERISTICS OF ORGAN FAILURE PATTERNS IN ACUTE PANCREATITIS

Intoroduction. Acute pancreatitis remains one of the most challenging diseases in abdominal surgery, particularly due to the high incidence of organ failure, occurring in 15-20% of patients and associated with mortality rates up to 42% during the first week of hospitalization. Early identification of patients at high risk for organ failure development is of particular importance. It, in turn, is a key factor determining the severity of the course and prognosis of the disease, developing in 15-20% of patients with acute pancreatitis. At the same time, persistent organ failure is associated with mortality of up to 42% during the first week of hospitalization. There are several scales for assessing the severity of acute pancreatitis, including: Acute Physiologic Assessment and Chronic Health Evaluation II, Bedside Index of Severity in Acute Pancreatitis and the modified Marshall scale, but none of them demonstrates accuracy in predicting the development of organ failure, and the maximum sensitivity reaches only 75%. The objective of this study was to identify and characterize the main patterns of organ failure in acute pancreatitis based on comprehensive analysis of clinical indicators, laboratory parameters, and temporal disease characteristics. Subjects and methods. This retrospective study included 82 patients (2014-2019), stratified into groups with organ failure (n=41) and without it (n=41). The assessment protocol included clinical parameters, laboratory findings, and disease progression dynamics. Cluster analysis was used to determine organ failure patterns. Results. Three main patterns were identified: “early respiratory” (37.5% of cases), “late progressive” (57.5%), and “multisystem” (5.0%), each differing in onset timing, organ system involvement, and clinical outcomes. The "multisystem" pattern exhibited the most unfavorable profile, with the longest hospitalization duration (median 68.0 days) and highest mortality. The study identified key prognostic markers and developed a risk stratification system, enabling optimized monitoring and treatment strategies based on the organ failure pattern.