scholarly journals Serum Creatinine Level and APACHE-II Score within 24 h of Admission Are Effective for Predicting Persistent Organ Failure in Acute Pancreatitis

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Jianhua Wan ◽  
Wenqing Shu ◽  
Wenhua He ◽  
Yin Zhu ◽  
Yong Zhu ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Serum Creatinine ◽  
Organ Failure ◽  
Classification Tree ◽  
Serum Levels ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Large Hospital ◽  
Persistent Organ Failure

Aim. The present study was aimed at comparing serum markers and APACHE-II score to predict persistent organ failure (POF) in early acute pancreatitis (AP). Methods. In this retrospective study, data from 6024 patients with AP were included within 24 h of their admission. Serum levels of urea nitrogen (BUN), creatinine, glucose, and hematocrit and APACHE-II score were analyzed for patients with AP. We employed the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, and specificity analyses to evaluate the accuracy of the studied laboratory parameters and APACHE-II score. Results. Our study included 2090 (35%) patients out of 6024 patients who were evaluated within 24 h of hospital admission. For predicting POF, serum creatinine level≥1.8 mg/dl had the highest specificity (98%). The second classification tree has shown that when the serum creatinine level>1.8 and APACHE−II≥8 within 24 h were combined, the rates of predicted persistent organ failure achieved 66.7%. Conclusions. In this large, hospital-based retrospective study, we demonstrated that an APACHE-II score≥8 and a serum creatinine level≥1.8 mg/dl within 24 h of admission can positively predict POF in AP and that serum creatinine levels<1.8 mg/dl within 24 h of admission can be useful for negatively predicting POF in AP.

scholarly journals Serum Hydroxybutyrate dehydrogenase as an early predictive marker of the severity of acute pancreatitis: a retrospective study

2020 ◽  
Author(s):  
weiming xiao ◽  
Weili Liu ◽  
Ling Yin ◽  
Yong Li ◽  
Guotao Lu ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Organ Failure ◽  
Early Stage ◽  
Laboratory Data ◽  
Elevated Serum ◽  
High Serum ◽  
Normal Serum ◽  
Receiver Operating Curve ◽  
Persistent Organ Failure

Abstract Background: To investigate the value of serum hydroxybutyrate dehydrogenase (HBDH) level, an isozyme of lactate dehydrogenase (LDH), in evaluating the severity of acute pancreatitis (AP).Methods: Patients diagnosed with AP from January 2013 to December 2018 were included in this retrospective study. Patients were divided into the normal serum HBDH levels group (n-HBDH group) and the high serum HBDH levels group (h-HBDH group) according to the criteria HBDH ≥ 182 U/L after admission. The demographic parameters, laboratory data and the severity of AP in the two groups were compared. The receiver operating curve (ROC) was used to evaluate the efficacy of serum HBDH in predicting persistent organ failure and systemic inflammatory response syndrome (SIRS).Results: A total of 260 AP patients were enrolled, including 176 cases in the n-HBDH group and 84 cases in the h-HBDH group. The incidence of SIRS and organ failure in the h-HBDH group were significantly higher than those in n-HBDH group (both P < 0.001). In addition, the HBDH level was significantly decreased in 110 patients who were re-measured after AP treatment. The serum HBDH levels were positively correlated with Atlanta classification, Ranson score, and BISAP score (all P < 0.05). ROC analysis showed that a serum HBDH cut-off point of 195.0 U/L had optimal predictive value for the development of persistent organ failure (AUC = 0.778) and 166.5 U/L for the development of SIRS (AUC = 0.724).Conclusion: The elevated serum HBDH in early stage of AP is closely related to the adverse prognosis of AP patients, which can be used as a potential early biomarker for predicting the severity of AP.

scholarly journals Serum hydroxybutyrate dehydrogenase as an early predictive marker of the severity of acute pancreatitis: a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Weiming Xiao ◽  
Weili Liu ◽  
Ling Yin ◽  
Yong Li ◽  
Guotao Lu ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Organ Failure ◽  
Early Stage ◽  
Laboratory Data ◽  
Elevated Serum ◽  
High Serum ◽  
Normal Serum ◽  
Receiver Operating Curve ◽  
Persistent Organ Failure

Abstract Background To investigate the value of serum hydroxybutyrate dehydrogenase (HBDH) level, an isozyme of lactate dehydrogenase, in evaluating the severity of acute pancreatitis (AP). Methods Patients diagnosed with AP from January 2013 to December 2018 were included in this retrospective study. Patients were divided into the normal serum HBDH levels group (n-HBDH group) and the high serum HBDH levels group (h-HBDH group) according to the criteria HBDH ≥ 182 U/L after admission. The demographic parameters, laboratory data and the severity of AP in the two groups were compared. The receiver operating curve (ROC) was used to evaluate the efficacy of serum HBDH in predicting persistent organ failure and systemic inflammatory response syndrome (SIRS). Results A total of 260 AP patients were enrolled, including 176 cases in the n-HBDH group and 84 cases in the h-HBDH group. The incidence of SIRS and organ failure in the h-HBDH group were significantly higher than those in n-HBDH group (both P < 0.001). In addition, the HBDH level was significantly decreased in 110 patients who were re-measured after AP treatment. The serum HBDH levels were positively correlated with Atlanta classification, Ranson score, and BISAP score (all P < 0.05). ROC analysis showed that a serum HBDH cut-off point of 195.0 U/L had optimal predictive value for the development of persistent organ failure (AUC = 0.778) and 166.5 U/L for the development of SIRS (AUC = 0.724). Conclusion The elevated serum HBDH in early stage of AP is closely related to the adverse prognosis of AP patients, which can be used as a potential early biomarker for predicting the severity of AP.

scholarly journals Serum Hydroxybutyrate dehydrogenase as an early predictive marker of the severity of acute pancreatitis: a retrospective study

2020 ◽  
Author(s):  
Weiming Xiao ◽  
Weili Liu ◽  
Ling Yin ◽  
Yong Li ◽  
Guotao Lu ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Organ Failure ◽  
Laboratory Data ◽  
Elevated Serum ◽  
Systemic Inflammatory Response ◽  
Receiver Operating Curve ◽  
Persistent Organ Failure

Abstract Background: Acute pancreatitis (AP) is an inflammatory disease caused by premature activation of the zymogen, which could lead to systemic inflammatory response syndrome (SIRS) and organ failure. Currently, some clinical multi-factor scoring systems have already been used to predict the occurrence of SAP, However, all these methods are complicated and difficult to obtain the first data.Methods: Patients diagnosed with AP from January 2013 to December 2018 were included in this retrospective study. Patients were divided into the normal serum HBDH levels group (n-HBDH group) and the high serum HBDH levels group (h-HBDH group) according to the HBDH ≥ 182U/L after admission. The demographic parameters, laboratory data and the severity of AP in the two groups were compared. The receiver operating curve (ROC) was used to evaluate the efficacy of serum HBDH in predicting persistent organ failure and systemic inflammatory response syndrome (SIRS).Results: A total of 260 AP patients were enrolled, including 176 cases in the n-HBDH group and 84 cases in the h-HBDH group. The incidence of SIRS and organ failure in the h-HBDH group were significantly higher than those in n-HBDH group (both P < 0.001). In addition, the serum HBDH levels were positively correlated with Atlanta classification, Ranson score, and BISAP score (all P < 0.05). ROC analysis showed that a serum HBDH cut-off point of 195.0 U/L had optimal predictive value for the development of persistent organ failure (AUC = 77.8%) and 166.5 U/L for the development of SIRS (AUC = 72.4%).Conclusion: The elevated serum HBDH in early stage of AP is closely related to the adverse prognosis of AP patients, which can be used as a potential early biomarker for the severity of AP.

scholarly journals Bernard Organ Failure Score in estimation of most severe forms of acute pancreatitis

2009 ◽  
Vol 137 (3-4) ◽  
pp. 166-170 ◽  
Author(s):  
Tijana Glisic ◽  
Ana Sijacki ◽  
Goran Vukovic ◽  
Vladimir Vukojevic ◽  
Aleksandar Subotic
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Disease Severity ◽  
Disease Onset ◽  
Scoring Systems ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Illness Onset ◽  
Number Of Patients ◽  
Organ Failure Score

Introduction. Despite intensive research, efforts and clinical investigations on pathogenesis of acute pancreatitis (AP) and system morbidity during the illness onset, mortality is still very high in the group of severe forms. A significantly high number of patients show moderate, self-limited forms of illness, with a minimal degree of systemic or local complications, with full recovery. However, some of them have a severe form, followed by a high percent of morbidity and mortality, and system organ failure. The distinction between mild and severe forms of AP within 24-48 hours of hospital admission is very important for the treatment of these patients. The usage of multifactorial scoring systems holds a lot of promise, reaching reliability in the disease severity estimation of approximately 70-80%. Objective. The main purpose of this prospective study was to assess the correlation of the Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Bernard Organ Failure Score (BOFS) scoring systems in estimation of disease severity and outcome prediction. Methods. Sixty patients with AP participated in the study, all of them scored with the APACHE II and BOFS scores. The results were used for integration of laboratory and clinical parameters. Results. In our study, we had a highly significant correlation between the APACHE II and BOFS scores from the disease onset until the end of treatment. There was a highly significant correlation between these two scores and the serum C-reactive protein concentration level. Conclusion. The concept of the BOFS score has more advantages than the APACHE II score in the patients with severe forms of AP with organ dysfunction.

scholarly journals Comparison of Multifactor Vs Independent Marker in Predicting Severity of Acute Pancreatitis

2020 ◽  
Vol 3 (1) ◽  
pp. 136-141
Author(s):  
Vijaykumar C Bada
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Pmn Elastase ◽  
Severe Pancreatitis ◽  
Poor Predictor ◽  
Score Apache ◽  
Pmn Élastase ◽  
Independent Marker

Background: Acute pancreatitis (AP) is an inflammatory process with a highly variable clinical course. This study was conducted to compare the multifactor vs independent marker in predicting the severity of acute pancreatitis. Subjects and Methods: The present study comprised    of 50 patients of acute pancreatitis. In all patients, reactive protein (CRP), Interleukin-6 (IL-6), PMN-Elastase (PMN-E), Procalcitonin (PCT), RANSON”s score, GLASGOW score, APACHE-II score, APACHE-O score and Balthazar’s CTSI score was recorded. Results: There were 45 males and 5 females in the study. There were 12 (22.64%) obese patients in this study. The age of the patients was a significant indicator    to discriminate or predict patients with mild or severe pancreatitis. With an AUROC of 0.6004, it was found that age was a poor predictor       of the severity of acute pancreatitis. Obesity of the patients was a significant indicator to discriminate or predict patients with mild or severe pancreatitis. With an AUROC of 0.6004, it was found that age is a poor predictor of the severity of acute pancreatitis. Organ failure at admission is more likely to reflect severe cases, it is found to be a poor predictor of severity in acute pancreatitis. The mean CTSI score in the study was 3.57 (SD 2.64), with a median of 2 and ranged from 1 to 10. It was higher in severe pancreatitis and a CTSI score of >=3 was significantly associated with patients with acute pancreatitis by bivariate analysis. Conclusion: The authors found that overall, CRP was the best predictor, followed by IL-6, CTSI score, PCT, Glasgow, Ranson’s and APACHE-II. PMN-Elastase, Age, obesity and organ failure at admission are poor predictors of severity of acute pancreatitis.

scholarly journals Serum Hydroxybutyrate dehydrogenase as an early predictive marker of the severity of acute pancreatitis: a retrospective study

2020 ◽  
Author(s):  
weiming xiao ◽  
Weili Liu ◽  
Ling Yin ◽  
Yong Li ◽  
Guotao Lu ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Organ Failure ◽  
Early Stage ◽  
Laboratory Data ◽  
Elevated Serum ◽  
High Serum ◽  
Normal Serum ◽  
Receiver Operating Curve ◽  
Persistent Organ Failure

Abstract Background: To investigate the value of serum hydroxybutyrate dehydrogenase (HBDH) level, an isozyme of lactate dehydrogenase (LDH), in evaluating the severity of acute pancreatitis (AP).Methods: Patients diagnosed with AP from January 2013 to December 2018 were included in this retrospective study. Patients were divided into the normal serum HBDH levels group (n-HBDH group) and the high serum HBDH levels group (h-HBDH group) according to the criteria HBDH ≥ 182 U/L after admission. The demographic parameters, laboratory data and the severity of AP in the two groups were compared. The receiver operating curve (ROC) was used to evaluate the efficacy of serum HBDH in predicting persistent organ failure and systemic inflammatory response syndrome (SIRS).Results: A total of 260 AP patients were enrolled, including 176 cases in the n-HBDH group and 84 cases in the h-HBDH group. The incidence of SIRS and organ failure in the h-HBDH group were significantly higher than those in n-HBDH group (both P < 0.001). In addition, the HBDH level was significantly decreased in 110 patients who were re-measured after AP treatment. The serum HBDH levels were positively correlated with Atlanta classification, Ranson score, and BISAP score (all P < 0.05). ROC analysis showed that a serum HBDH cut-off point of 195.0 U/L had optimal predictive value for the development of persistent organ failure (AUC = 0.778) and 166.5 U/L for the development of SIRS (AUC = 0.724).Conclusion: The elevated serum HBDH in early stage of AP is closely related to the adverse prognosis of AP patients, which can be used as a potential early biomarker for predicting the severity of AP.

scholarly journals SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323364
Author(s):  
Sanjay Pandanaboyana ◽  
John Moir ◽  
John S Leeds ◽  
Kofi Oppong ◽  
Aditya Kanwar ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Stay ◽  
Organ Failure ◽  
Collaborative Study ◽  
Length Of Hospital Stay ◽  
Secondary Outcome ◽  
Icu Admission ◽  
Local Complications ◽  
Persistent Organ Failure ◽  
Increased Risk

ObjectiveThere is emerging evidence that the pancreas may be a target organ of SARS-CoV-2 infection. This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and coexistent SARS-CoV-2 infection.DesignA prospective international multicentre cohort study including consecutive patients admitted with AP during the current pandemic was undertaken. Primary outcome measure was severity of AP. Secondary outcome measures were aetiology of AP, intensive care unit (ICU) admission, length of hospital stay, local complications, acute respiratory distress syndrome (ARDS), persistent organ failure and 30-day mortality. Multilevel logistic regression was used to compare the two groups.Results1777 patients with AP were included during the study period from 1 March to 23 July 2020. 149 patients (8.3%) had concomitant SARS-CoV-2 infection. Overall, SARS-CoV-2-positive patients were older male patients and more likely to develop severe AP and ARDS (p<0.001). Unadjusted analysis showed that SARS-CoV-2-positive patients with AP were more likely to require ICU admission (OR 5.21, p<0.001), local complications (OR 2.91, p<0.001), persistent organ failure (OR 7.32, p<0.001), prolonged hospital stay (OR 1.89, p<0.001) and a higher 30-day mortality (OR 6.56, p<0.001). Adjusted analysis showed length of stay (OR 1.32, p<0.001), persistent organ failure (OR 2.77, p<0.003) and 30-day mortality (OR 2.41, p<0.04) were significantly higher in SARS-CoV-2 co-infection.ConclusionPatients with AP and coexistent SARS-CoV-2 infection are at increased risk of severe AP, worse clinical outcomes, prolonged length of hospital stay and high 30-day mortality.

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