title: Comparing acid steatocrit and faecal elastase estimations for use in M-ANNHEIM staging for pancreatitis.
abstract: OBJECTIVE
  To compare two tests for exocrine pancreatic function (EPF) for use in M-ANNHEIM staging for pancreatitis.
  
  
  METHODS
  One hundred and ninety four consecutive patients with acute pancreatitis (AP;n= 13), recurrent acute pancreatitis (RAP;n= 65) and chronic pancreatitis (CP;n= 116) were enrolled. EPF was assessed by faecal elastase-1 (FE-1) estimation and stool fat excretion by the acid steatocrit method. Patients were classified as per M-ANNHEIM stages separately based on the results of the two tests for comparison. Independent Student'st-test, χ2test, Kruskal-Wallis test, Mann-WhitneyUtest and McNemar's test were used as appropriate.
  
  
  RESULTS
  Sixty-one (52.5%) patients with CP had steatorrhoea when assessed by the acid steatocrit method; 79 (68.1%) with CP had exocrine insufficiency by the FE-1 test (χ2test,P< 0.001). The results of acid steatocrit and FE-1 showed a significant negative correlation (Spearman's rho = -0.376,P< 0.001). A statistically significant difference was seen between the M-ANNHEIM stages as classified separately by acid steatocrit and the FE-1. Thirteen (6.7%), 87 (44.8%), 89 (45.8%) and 5 (2.5%) patients were placed in M-ANNHEIM stages 0, I, II, and III respectively, with the use of acid steatocrit as against 13 (6.7%), 85 (43.8%), 75 (38.6%), and 21 (10.8%) respectively by FE-1 in stages 0, I, II, and III thereby altering the stage in 28 (14.4%) patients (P< 0.001, McNemar's test).
  
  
  CONCLUSIONS
  FE-1 estimation performed better than the acid steatocrit test for use in the staging of pancreatitis by the M-ANNHEIM classification since it diagnosed a higher proportion of patients with exocrine insufficiency.
authors.affiliation: M Ganesh Kamath, Department of Physiology, Melaka Manipal Medical College, Manipal University, Manipal 576104, India.
authors.forename: M Ganesh
authors.initials: MG
authors.lastname: Kamath
authors.affiliation: M Ganesh Kamath, Department of Physiology, Melaka Manipal Medical College, Manipal University, Manipal 576104, India.
authors.forename: C Ganesh
authors.initials: CG
authors.lastname: Pai
authors.affiliation: M Ganesh Kamath, Department of Physiology, Melaka Manipal Medical College, Manipal University, Manipal 576104, India.
authors.forename: Asha
authors.initials: A
authors.lastname: Kamath
authors.affiliation: M Ganesh Kamath, Department of Physiology, Melaka Manipal Medical College, Manipal University, Manipal 576104, India.
authors.forename: Annamma
authors.initials: A
authors.lastname: Kurien
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000032:analysis*; D010186:Pancreatic Function Tests / Q000379:methods; D010195:Pancreatitis / Q000175:diagnosis*; D019512:Pancreatitis, Alcoholic / Q000175:diagnosis; D050500:Pancreatitis, Chronic / Q000175:diagnosis; D012720:Severity of Illness Index; D045602:Steatorrhea / Q000150:complications
chemical_list: D010196:Pancreatic Elastase
keywords: Chronic pancreatitis; Pancreatic elastase; Pancreatic function tests; Staging; Steatorrhoea