title: Clinico-biochemical factors to early predict biliary etiology of acute pancreatitis: age, female gender, and ALT.
abstract: Background/ Aims: Despite the existence of an easy tool to diagnose biliary tract disease as an etiology for acute pancreatitis (AP), the sensitivity of abdominal ultrasound is around 80%, which can be even lower in certain conditions.
  
  
  METHODS
  We have retrospectively reviewed data of 146 patients admitted for acute pancreatitis between 1999 and 2013. Bivariate analysis for clinical and biochemical variables was performed with respect to etiology of AP (biliary versus non-biliary). Multivariate analysis was performed by using binary logistic regression.
  
  
  RESULTS
  There were 87 males (59.6%) and 59 females (40.4%), with a median age of 51. The etiology of acute pancreatitis was biliary in 71 patients (48.6%). Bivariate analysis found the following as significant association (p=0.001) with biliary pancreatitis: older age, female gender, and elevated AST, ALT. A binary logistic regression analysis identified as predictor factors for biliary etiology of acute pancreatitis: age OR = 1.031 (95% CI 1.004 - 1.059, p = 0.024), sex (female) OR = 2.34 (95% CI 1.022 - 5.359, p = 0.044) and ALT OR = 1.004 (95% CI 1.001 - 1.007, p =0.004). The two clinical scores included the three variables (A.S.ALT scores) in categorical format were generated and then checked with the ROC curves (areas under curve are 0.768 and 0.778).
  
  
  CONCLUSIONS
  Age, female gender, and elevated ALT can help identifying cases with biliary etiology of acute pancreatitis.
authors.affiliation: Second Department of Surgery, University Emergency Hospital Bucharest, Romania ; "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania.
authors.forename: N O
authors.initials: NO
authors.lastname: Zarnescu
authors.affiliation: Second Department of Surgery, University Emergency Hospital Bucharest, Romania ; "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania.
authors.forename: R
authors.initials: R
authors.lastname: Costea
authors.affiliation: Second Department of Surgery, University Emergency Hospital Bucharest, Romania.
authors.forename: E C
authors.initials: EC
authors.lastname: Zarnescu Vasiliu
authors.affiliation: Second Department of Surgery, University Emergency Hospital Bucharest, Romania ; "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania.
authors.forename: S
authors.initials: S
authors.lastname: Neagu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism*; D001659:Biliary Tract / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000201:enzymology* / Q000209:etiology*; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012727:Sex Characteristics
chemical_list: D000410:Alanine Transaminase
keywords: acute pancreatitis; biliary pancreatitis; biochemical prediction; gallstone; risk score