Biochemical models as early predictors of the etiology of acute pancreatitis.
In this study we observed the discriminative ability of five commonly measured laboratory tests to distinguish between gallstone- and non-gallstone-associated pancreatitis. We also assessed the ability of the lipase-amylase ratio to discriminate between alcohol- and non-alcohol-induced pancreatitis. One hundred sixty-two patients with acute pancreatitis were included in the study. Group A consisted of patients presenting to our hospital in 1988 and 1989. Group B consisted of patients presenting in 1992. Models developed using group A patients were validated using group B patients. For gallstone pancreatitis, AST (threshold value 80 IU/liter) alone and a three-factor model, AST, ALP and bilirubin (threshold values of 80 IU/liter, 115 IU/liter, and 15 mumol/liter, respectively) were the best predictors, correctly classifying at least 80% of cases in group A and B. A lipase-amylase ratio of two correctly classified only 48% of cases in group A and 54% in group B. We conclude that biochemical models are useful in predicting the presence of gallstone pancreatitis but not alcoholic pancreatitis.
Sadowski
D C
DC
Gastrointestinal Disease Research Group, University of Calgary, Alberta, Canada.
Todd
J K
JK
Sutherland
L R
LR
D000208:Acute Disease; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000175:diagnosis; D000681:Amylases / Q000097:blood; D002769:Cholelithiasis / Q000150:complications / Q000175:diagnosis; D004796:Clinical Enzyme Tests / Q000706:statistics & numerical data; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity
D008049:Lipase; D000681:Amylases