title: Simplified admission criterion for predicting severe complications of gallstone pancreatitis.
abstract: OBJECTIVE
  Simple admission criteria (white blood cell count, > or =14. 5 x 10(9)/L; blood urea nitrogen level, > or =4.3 mmol/L [> or =12 mg/dL]; heart rate, > or =100 beats per minute; and serum glucose level, > or =8.3 mmol/L [> or =150 mg/dL]) are better predictors of severe complications of gallstone pancreatitis than an Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 5 or greater, a modified Imrie (Glasgow) score of 3 or greater, and a biliary Ranson score of 3 or greater.
  
  
  METHODS
  A prospective consecutive case study.
  
  
  METHODS
  A university-affiliated, urban, public hospital.
  
  
  METHODS
  Ninety-two consecutive patients (77 women and 15 men, aged 18 to 76 years [mean age, 39 years]) with gallstone pancreatitis. Seventy-seven patients were Hispanic.
  
  
  METHODS
  Major local and systemic complications requiring intensive care unit care, and death.
  
  
  RESULTS
  Fourteen patients (15%) had severe complications with a mortality of 2%. On univariate analysis, a white blood cell count of 14.5 x 10(9)/L or more (P =.03), a serum glucose level of 8. 3 mmol/L or more (> or =150 mg/dL) (P<.001), an APACHE II score of 5 or greater (P =.008), a modified Imrie score of 3 or greater (P<.001), and a biliary Ranson score of 3 or greater (P =.03) were statistically associated with the development of severe complications; whereas a blood urea nitrogen level of 4.3 mmol/L or more (> or =12 mg/dL) and a heart rate of 100 beats per minute or more were not. On multivariate analysis, only a serum glucose level of 8. 3 mmol/L or more (> or =150 mg/dL) was predictive of adverse events (P<. 001).
  
  
  CONCLUSIONS
  Glucose level (> or =8.3 mmol/L [> or =150 mg/dL]) is the best single admission predictor of severe complications of gallstone pancreatitis and is superior to an APACHE II score of 5 or greater, a modified Imrie score of 3 or greater, and a biliary Ranson score of 3 or greater.
authors.affiliation: Department of Surgery, Harbor-UCLA Medical Center, 1000 W Carson St, Box 25, Torrance, CA 90509, USA.
authors.forename: K
authors.initials: K
authors.lastname: Meek
authors.forename: K
authors.initials: K
authors.lastname: Toosie
authors.forename: B E
authors.initials: BE
authors.lastname: Stabile
authors.forename: M
authors.initials: M
authors.lastname: Elbassir
authors.forename: Z
authors.initials: Z
authors.lastname: Murrell
authors.forename: R J
authors.initials: RJ
authors.lastname: Lewis
authors.forename: L
authors.initials: L
authors.lastname: Chang
authors.forename: C
authors.initials: C
authors.lastname: de Virgilio
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002769:Cholelithiasis / Q000150:complications*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index
chemical_list: D001786:Blood Glucose