title: Prediction of the severity of acute pancreatitis on admission by urinary trypsinogen activation peptide: a meta-analysis.
abstract: OBJECTIVE
  To undertake a meta-analysis on the value of urinary trypsinogen activation peptide (uTAP) in predicting severity of acute pancreatitis on admission.
  
  
  METHODS
  Major databases including Medline, Embase, Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials in the Cochrane Library were searched to identify all relevant studies from January 1990 to January 2013. Pooled sensitivity, specificity and the diagnostic odds ratios (DORs) with 95%CI were calculated for each study and were compared to other systems/biomarkers if mentioned within the same study. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated.
  
  
  RESULTS
  In total, six studies of uTAP with a cut-off value of 35 nmol/L were included in this meta-analysis. Overall, the pooled sensitivity and specificity of uTAP for predicting severity of acute pancreatitis, at time of admission, was 71% and 75%, respectively (AUC = 0.83, DOR = 8.67, 95%CI: 3.70-20.33). When uTAP was compared with plasma C-reactive protein, the pooled sensitivity, specificity, AUC and DOR were 0.64 vs 0.67, 0.77 vs 0.75, 0.82 vs 0.79 and 6.27 vs 6.32, respectively. Similarly, the pooled sensitivity, specificity, AUC and DOR of uTAP vs Acute Physiology and Chronic Health Evaluation II within the first 48 h of admission were found to be 0.64 vs 0.69, 0.77 vs 0.61, 0.82 vs 0.73 and 6.27 vs 4.61, respectively.
  
  
  CONCLUSIONS
  uTAP has the potential to act as a stratification marker on admission for differentiating disease severity of acute pancreatitis.
authors.affiliation: Sichuan Provincial Pancreatitis Center, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: Kiran
authors.initials: K
authors.lastname: Altaf
authors.forename: Tao
authors.initials: T
authors.lastname: Jin
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Xiong
authors.forename: Li
authors.initials: L
authors.lastname: Wen
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Javed
authors.forename: Marianne
authors.initials: M
authors.lastname: Johnstone
authors.forename: Ping
authors.initials: P
authors.lastname: Xue
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Halloran
authors.forename: Qing
authors.initials: Q
authors.lastname: Xia
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009842:Oligopeptides / Q000652:urine*; D010195:Pancreatitis / Q000175:diagnosis* / Q000652:urine; D010343:Patient Admission; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D009842:Oligopeptides; C080396:trypsinogen activation peptide
keywords: Acute Physiology and Chronic Health Evaluation II score; Acute pancreatitis; C-reactive protein; Meta-analysis; Urinary trypsinogen activation peptide
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