Is there correlation between pancreatic enzyme and radiological severity in acute pancreatitis?
OBJECTIVE
To investigate the correlation between the changes of pancreatic enzyme, the biochemical markers and the clinical results according to the Balthazar computer tomography (CT) grade.


METHODS
Between July 2004 and July 2005, we reviewed the charts of 119 patients who were admitted to our hospital with acute pancreatitis.


RESULTS
Eighty-three patients (69.7%) were male, and the mean age of the patients was 57 +/- 15.7 years. The biliary pancreatitis patients had an older mean age. Forty-nine patients (41.1%) had biliary pancreatitis and forty-six (38.6%) had alcoholic pancreatitis. Group 3 patients had a longer duration of pain (2.51 +/- 1.16 vs 3.17 +/- 1.30 vs 6.56 +/- 6.13, P < 0.001), a longer period of fasting (7.49 +/- 4.65 vs 10.65 +/- 5.54 vs 21.88 +/- 13.81, P < 0.001) and a longer hospital stay (9.17 +/- 5.34 vs 14.63 +/- 8.65 vs 24.47 +/- 15.52, P < 0.001) than the other groups. On the univariate analysis, the factors that affected the radiological grade were the leukocyte count at admission (P = 0.048), the hemoglobin (P = 0.016) and total bilirubin concentrations (P = 0.023), serum lipase (P = 0.009), the APACH II scores at admission (P = 0.017), the APACH II scores after 24 h (P = 0.031), the C-reactive protein (CRP) titer (P = 0.0001) and the follow up CRP titer (P = 0.003). But the CRP level (P = 0.001) and follow up CRP titer (P = 0.004) were only correlated with the radiological grade on multivariate analysis. According to the ROC curve, when we set the CRP cut off value at 83 mg/L, the likelihood ratio for a positive test was 3.84 and the likelihood ratio for a negative test was 0.26 in group 3.


CONCLUSIONS
In conclusion, our study suggests that the CRP with the radiological severity may be used to estimate the severity of acute pancreatitis.
Kim
Yeon Soo
YS
Department of Internal Medicine, Daejeon St. Mary's Hospital Medical College of the Catholic University of Korea, Korea.
Lee
Byung Seok
BS
Kim
Seok Hyun
SH
Seong
Jae Kyu
JK
Jeong
Hyun Yong
HY
Lee
Heon Young
HY
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000201:enzymology*; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000201:enzymology* / Q000209:etiology; D011237:Predictive Value of Tests; D012372:ROC Curve; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D002097:C-Reactive Protein; D008049:Lipase; C518354:PNLIP protein, human; D000681:Amylases