Correlation between admission laboratory values, early abdominal computed tomography, and severe complications of gallstone pancreatitis.
BACKGROUND
Our previous study demonstrated that Balthazar grade D or E pancreatitis on early abdominal computed tomography (CT) scan correlated with severe complications of gallstone pancreatitis (GP).


OBJECTIVE
To compare the efficacy of individual admission laboratory criteria, multiple criteria scoring systems and CT scan for predicting severe complications of GP.


METHODS
Consecutively admitted patients with GP underwent selective early CT scanning (<72 hours). All patients were prospectively monitored for severe complications.


RESULTS
Of the 66 patients studied, 21 (32%) did not undergo for early CT scanning and underwent cholecystectomy with no complications. Forty-five patients (68%) had an early abdominal CT scan. Of the 12 patients with grade E pancreatitis, 6 (50%) developed severe complications versus only 2 of 33 (6%) with grade A to D pancreatitis (P = 0.002). A significant correlation was found between admission white blood cell count > or =14.5 x 10(9)/L and grade E pancreatitis on early CT scan (P = 0.002). However, admission glucose > or =150 mg/dL was the best predictor of complications (sensitivity 100%, negative predictive value 100%).


CONCLUSIONS
Although Balthazar grade E on early CT scan correlates with severe complications of GP, admission glucose > or =150 mg/dL has a better sensitivity and negative predictive value, is quicker to use, and is more cost-effective as a prognostic indicator.
Meek
K
K
Department of Surgery, Harbor-UCLA Medical Center, Torrance, California, USA.
de Virgilio
C
C
Murrell
Z
Z
Stabile
B E
BE
Elbassir
M
M
Renslo
R
R
Toosie
K
K
D000208:Acute Disease; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002769:Cholelithiasis / Q000097:blood / Q000150:complications*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000097:blood / Q000150:complications*; D011379:Prognosis; D011860:Radiography, Abdominal; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D001786:Blood Glucose