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

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.

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

10.21203/rs.3.rs-39346/v2 ◽

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.

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

10.21203/rs.3.rs-39346/v1 ◽

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.

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Platelet Distribution Width Levels Can Be a Predictor in the Diagnosis of Persistent Organ Failure in Acute Pancreatitis

Gastroenterology Research and Practice ◽

10.1155/2017/8374215 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Feiyang Wang ◽

Zibo Meng ◽

Shoukang Li ◽

Yushun Zhang ◽

Heshui Wu

Keyword(s):

Acute Pancreatitis ◽

Organ Failure ◽

Multivariable Analysis ◽

Laboratory Data ◽

Area Under The Curve ◽

Platelet Distribution Width ◽

Distribution Width ◽

Persistent Organ Failure ◽

Failure Assessment ◽

Potential Prognostic Factor

Purpose. The change of serum platelet indices such as platelet distribution width (PDW) has been reported in a series of inflammatory reaction and clinical diseases. However, the relationship between PDW and the incidence of persistent organ failure (POF) in acute pancreatitis (AP) has not been elucidated so far.Materials and Methods. A total of 135 patients with AP admitted within 72 hours from symptom onset of AP at our center between December 2014 and January 2016 were included in this retrospective study. Demographic parameters on admission, organ failure assessment, laboratory data, and in-hospital mortality were compared between patients with and without POF. Multivariable logistic regression analyses were utilized to evaluate the predictive value of serum PDW for POF.Results. 30 patients were diagnosed with POF. Compared to patients without POF, patients with POF showed a significantly higher value of serum PDW on admission (14.88 ± 2.24 versus 17.60 ± 1.96%,P<0.001). After multivariable analysis, high PDW level remained a risk factor for POF (odds ratio 39.42, 95% CI: 8.64–179.77;P<0.001). A PDW value of 16.45% predicted POF with an area under the curve (AUC) of 0.870, a sensitivity with 0.867, and a specificity with 0.771, respectively.Conclusions. Our results indicate that serum PDW on admission could be a predictive factor in AP with POF and may serve as a potential prognostic factor.

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Elevated Serum Triglycerides Associated With Systemic Inflammatory Response Syndrome and Persistent Organ Failure in Acute Pancreatitis

The American Journal of Gastroenterology ◽

10.1038/ajg.2015.388 ◽

2016 ◽

Vol 111 (1) ◽

pp. 149 ◽

Cited By ~ 3

Author(s):

Emmanuel I González-Moreno ◽

José A González-González ◽

Elvira Garza-González ◽

Francisco J Bosques-Padilla ◽

Héctor J Maldonado-Garza

Keyword(s):

Acute Pancreatitis ◽

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Organ Failure ◽

Elevated Serum ◽

Systemic Inflammatory Response ◽

Serum Triglycerides ◽

Persistent Organ Failure

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

Gastroenterology Research and Practice ◽

10.1155/2019/8201096 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 1

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.

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SERUM ALBUMIN LEVEL IN PERSISTENT ORGAN FAILURE IN ACUTE PANCREATITIS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i5.232 ◽

2019 ◽

Vol 3 (5) ◽

Author(s):

Dr. Shefali Mehta ◽

Dr. Shuchi Goyal ◽

Dr. Rajendra Triloki ◽

Dr. A. K. Verma

Keyword(s):

Acute Pancreatitis ◽

Serum Albumin ◽

Organ Failure ◽

Serum Albumin Level ◽

Rapid Assessment ◽

Elevated Serum ◽

Albumin Level ◽

Persistent Organ Failure ◽

Increased Risk ◽

Patient Department

Introduction: The research emphasises on the association bond of Serum Albumin Level used as a marker for diagnosis of Persistent Organ Failure in Acute Pancreatitis. Material and Methods: The samples for the study were collected from the central lab, out-patient department and in-patient department of Department of Biochemistry, adult patients suffering from Acute Pancreatitis correlated to tropical medicinal stream and Gastroenterology Rabindranath Tagore Medical College, Udaipur, Rajasthan The research was carried out on a total of 100 patients for 1 year which were satisfying Atlanta criteria for Acute Pancreatitis will be diagnosed based on the following symptoms; elevated serum amylase, and lipase levels, that is greater than the normal limit, findings associated with the characteristics of the radiological findings. Also, with the abdominal computerized ultrasonography and tomography Results: In the present research, albumin always descends obviously in AP patients with POF (p < 0.05). The AUC under ROC line is 0.869. Albumin has been proved as an excellent marker of POF in AP. However, no previous study has researched into the association between albumin and incidence of POF in AP. Therefore, this study is the first time to show that the reduction of serum albumin is significantly associated with increased risk of POF in AP. Conclusion: Thus it can be concluded that serum albumin on admission is independently associated with POF in AP. The study suggests that albumin is a valuable tool for a rapid assessment of POF in patients with AP. Keywords: Serum Albumin, Persistent Organ Failure, Acute Pancreatitis

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Elevated Serum Triglycerides are Independently Associated With Persistent Organ Failure in Acute Pancreatitis

The American Journal of Gastroenterology ◽

10.1038/ajg.2015.261 ◽

2015 ◽

Vol 110 (10) ◽

pp. 1497-1503 ◽

Cited By ~ 91

Author(s):

Haq Nawaz ◽

Efstratios Koutroumpakis ◽

Jeffrey Easler ◽

Adam Slivka ◽

David C Whitcomb ◽

...

Keyword(s):

Acute Pancreatitis ◽

Organ Failure ◽

Elevated Serum ◽

Serum Triglycerides ◽

Persistent Organ Failure

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Early on‐demand drainage or standard management for acute pancreatitis patients with acute necrotic collections and persistent organ failure: a pilot randomized controlled trial

Journal of Hepato-Biliary-Pancreatic Sciences ◽

10.1002/jhbp.915 ◽

2021 ◽

Author(s):

Lu Ke ◽

Xiaowu Dong ◽

Tao Chen ◽

Gordon S. Doig ◽

Gang Li ◽

...

Keyword(s):

Acute Pancreatitis ◽

Randomized Controlled Trial ◽

Organ Failure ◽

Controlled Trial ◽

On Demand ◽

Randomized Controlled ◽

Persistent Organ Failure ◽

Standard Management ◽

Pilot Randomized Controlled Trial

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

Gut ◽

10.1136/gutjnl-2020-323364 ◽

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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